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House File 891 - ReprintedA Bill ForAn Act 1relating to appropriations for health and human
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2021-2022
3 Section 1. DEPARTMENT ON AGING. There is appropriated from
4the general fund of the state to the department on aging for
5the fiscal year beginning July 1, 2021, and ending June 30,
62022, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60
10years of age and older with case management, Iowa’s aging and
11disabilities resource center, and other services which may
12include but are not limited to adult day, respite care, chore,
13information and assistance, and material aid, for information
14and options counseling for persons with disabilities who
15are 18 years of age or older, and for salaries, support,
16administration, maintenance, and miscellaneous purposes, and
17for not more than the following full-time equivalent positions:
.................................................. $1811,304,082
............................................... FTEs1927.00
201. Funds appropriated in this section may be used to
21supplement federal funds under federal regulations. To
22receive funds appropriated in this section, a local area
23agency on aging shall match the funds with moneys from other
24sources according to rules adopted by the department. Funds
25appropriated in this section may be used for elderly services
26not specifically enumerated in this section only if approved
27by an area agency on aging for provision of the service within
28the area.
292. Of the funds appropriated in this section, $418,700 is
30transferred to the economic development authority for the Iowa
31commission on volunteer services to be used for the retired and
32senior volunteer program.
333. a. The department on aging shall establish and enforce
34procedures relating to expenditure of state and federal funds
35by area agencies on aging that require compliance with both
-1-1state and federal laws, rules, and regulations, including but
2not limited to all of the following:
3(1) Requiring that expenditures are incurred only for goods
4or services received or performed prior to the end of the
5fiscal period designated for use of the funds.
6(2) Prohibiting prepayment for goods or services not
7received or performed prior to the end of the fiscal period
8designated for use of the funds.
9(3) Prohibiting prepayment for goods or services not
10defined specifically by good or service, time period, or
11recipient.
12(4) Prohibiting the establishment of accounts from which
13future goods or services which are not defined specifically by
14good or service, time period, or recipient, may be purchased.
15b. The procedures shall provide that if any funds are
16expended in a manner that is not in compliance with the
17procedures and applicable federal and state laws, rules, and
18regulations, and are subsequently subject to repayment, the
19area agency on aging expending such funds in contravention of
20such procedures, laws, rules and regulations, not the state,
21shall be liable for such repayment.
224. Of the funds appropriated in this section, at least
23$600,000 shall be used to fund home and community-based
24services through the area agencies on aging that enable older
25individuals to avoid more costly utilization of residential or
26institutional services and remain in their own homes.
275. Of the funds appropriated in this section, $812,000 shall
28be used for the purposes of chapter 231E and to administer
29the prevention of elder abuse, neglect, and exploitation
30program pursuant to section 231.56A, in accordance with the
31requirements of the federal Older Americans Act of 1965, 42
32U.S.C.§3001 et seq., as amended.
336. Of the funds appropriated in this section, $1,000,000
34shall be used to fund continuation of the aging and disability
35resource center lifelong links to provide individuals and
-2-1caregivers with information and services to plan for and
2maintain independence.
37. Of the funds appropriated in this section, $250,000
4shall be used by the department on aging, in collaboration with
5the department of human services and affected stakeholders,
6to continue to expand the pilot initiative to provide
7long-term care options counseling utilizing support planning
8protocols, to assist non-Medicaid eligible consumers who
9indicate a preference to return to the community and are
10deemed appropriate for discharge, to return to their community
11following a nursing facility stay. The department on aging
12shall submit a report regarding the outcomes of the pilot
13initiative to the governor and the general assembly by December
1415, 2021.
15DIVISION II
16OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2021-2022
17 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
18appropriated from the general fund of the state to the office
19of long-term care ombudsman for the fiscal year beginning July
201, 2021, and ending June 30, 2022, the following amount, or
21so much thereof as is necessary, to be used for the purposes
22designated:
23For salaries, support, administration, maintenance, and
24miscellaneous purposes, and for not more than the following
25full-time equivalent positions:
.................................................. $261,149,821
............................................... FTEs2716.00
28DIVISION III
29DEPARTMENT OF PUBLIC HEALTH — FY 2021-2022
30 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
31from the general fund of the state to the department of public
32health for the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the following amounts, or so much thereof as is
34necessary, to be used for the purposes designated:
351. ADDICTIVE DISORDERS
-3- 1For reducing the prevalence of the use of tobacco, alcohol,
2and other drugs, and treating individuals affected by addictive
3behaviors, including gambling, and for not more than the
4following full-time equivalent positions:
.................................................. $523,659,379
............................................... FTEs612.00
7a. (1) Of the funds appropriated in this subsection,
8$4,020,894 shall be used for the tobacco use prevention
9and control initiative, including efforts at the state and
10local levels, as provided in chapter 142A. The commission
11on tobacco use prevention and control established pursuant
12to section 142A.3 shall advise the director of public health
13in prioritizing funding needs and the allocation of moneys
14appropriated for the programs and initiatives. Activities
15of the programs and initiatives shall be in alignment with
16the United States centers for disease control and prevention
17best practices for comprehensive tobacco control programs
18that include the goals of preventing youth initiation of
19tobacco usage, reducing exposure to secondhand smoke, and
20promotion of tobacco cessation. To maximize resources,
21the department shall determine if third-party sources are
22available to instead provide nicotine replacement products
23to an applicant prior to provision of such products to an
24applicant under the initiative. The department shall track and
25report to the governor and the general assembly any reduction
26in the provision of nicotine replacement products realized
27by the initiative through implementation of the prerequisite
28screening.
29(2) (a) The department shall collaborate with the
30alcoholic beverages division of the department of commerce for
31enforcement of tobacco laws, regulations, and ordinances and to
32engage in tobacco control activities approved by the division
33of tobacco use prevention and control of the department of
34public health as specified in the memorandum of understanding
35entered into between the divisions.
-4- 1(b) For the fiscal year beginning July 1, 2021, and ending
2June 30, 2022, the terms of the memorandum of understanding,
3entered into between the division of tobacco use prevention
4and control of the department of public health and the
5alcoholic beverages division of the department of commerce,
6governing compliance checks conducted to ensure licensed retail
7tobacco outlet conformity with tobacco laws, regulations, and
8ordinances relating to persons under 21 years of age, shall
9continue to restrict the number of such checks to one check per
10retail outlet, and one additional check for any retail outlet
11found to be in violation during the first check.
12b. (1) Of the funds appropriated in this subsection,
13$19,638,485 shall be used for problem gambling and
14substance-related disorder prevention, treatment, and recovery
15services, including a 24-hour helpline, public information
16resources, professional training, youth prevention, and program
17evaluation.
18(2) Of the amount allocated under this paragraph, $306,000
19shall be utilized by the department of public health, in
20collaboration with the department of human services, to
21maintain a single statewide 24-hour crisis hotline for the Iowa
22children’s behavioral health system that incorporates warmline
23services which may be provided through expansion of existing
24capabilities maintained by the department of public health as
25required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
26c. The requirement of section 123.17, subsection 5, is met
27by the appropriations and allocations made in this division of
28this Act for purposes of substance-related disorder treatment
29and addictive disorders for the fiscal year beginning July 1,
302021.
312. HEALTHY CHILDREN AND FAMILIES
32For promoting the optimum health status for children and
33adolescents from birth through 21 years of age, and families,
34and for not more than the following full-time equivalent
35positions:
-5-.................................................. $15,816,681
............................................... FTEs214.00
3a. Of the funds appropriated in this subsection, not more
4than $734,000 shall be used for the healthy opportunities for
5parents to experience success (HOPES)-healthy families Iowa
6(HFI) program established pursuant to section 135.106.
7b. In order to implement the legislative intent stated
8in sections 135.106 and 256I.9, priority for home visitation
9program funding shall be given to programs using evidence-based
10or promising models for home visitation.
11c. Of the funds appropriated in this subsection, $3,075,000
12shall be used for continuation of the department’s initiative
13to provide for adequate developmental surveillance and
14screening during a child’s first five years. The funds shall
15be used first to fully fund the current sites to ensure that
16the sites are fully operational, with the remaining funds
17to be used for expansion to additional sites. The full
18implementation and expansion shall include enhancing the scope
19of the initiative through collaboration with the child health
20specialty clinics to promote healthy child development through
21early identification and response to both biomedical and social
22determinants of healthy development; by monitoring child
23health metrics to inform practice, document long-term health
24impacts and savings, and provide for continuous improvement
25through training, education, and evaluation; and by providing
26for practitioner consultation particularly for children with
27behavioral conditions and needs. The department of public
28health shall also collaborate with the Iowa Medicaid enterprise
29and the child health specialty clinics to integrate the
30activities of the first five initiative into the establishment
31of patient-centered medical homes, community utilities,
32accountable care organizations, and other integrated care
33models developed to improve health quality and population
34health while reducing health care costs. To the maximum extent
35possible, funding allocated in this paragraph shall be utilized
-6-1as matching funds for medical assistance program reimbursement.
2d. Of the funds appropriated in this subsection, $64,000
3shall be distributed to a statewide dental carrier to provide
4funds to continue the donated dental services program patterned
5after the projects developed by the dental lifeline network to
6provide dental services to indigent individuals who are elderly
7or with disabilities.
8e. Of the funds appropriated in this subsection, $156,000
9shall be used to provide audiological services and hearing aids
10for children.
11f. Of the funds appropriated in this subsection, $23,000 is
12transferred to the university of Iowa college of dentistry for
13provision of primary dental services to children. State funds
14shall be matched on a dollar-for-dollar basis. The university
15of Iowa college of dentistry shall coordinate efforts with the
16department of public health, oral and health delivery system
17bureau, to provide dental care to underserved populations
18throughout the state.
19g. Of the funds appropriated in this subsection, $50,000
20shall be used to address youth suicide prevention.
21h. Of the funds appropriated in this subsection, $40,000
22shall be used to support the Iowa effort to address the survey
23of children who experience adverse childhood experiences known
24as ACEs.
25i. Of the funds appropriated in this subsection, up to
26$494,000 shall be used for childhood obesity prevention.
273. CHRONIC CONDITIONS
28For serving individuals identified as having chronic
29conditions or special health care needs, and for not more than
30the following full-time equivalent positions:
.................................................. $314,258,373
............................................... FTEs3210.00
33a. Of the funds appropriated in this subsection, $188,000
34shall be used for grants to individual patients who have an
35inherited metabolic disorder to assist with the costs of
-7-1medically necessary foods and formula.
2b. Of the funds appropriated in this subsection, $1,055,000
3shall be used for the brain injury services program pursuant
4to section 135.22B, including $861,000 for contracting with an
5existing nationally affiliated and statewide organization whose
6purpose is to educate, serve, and support Iowans with brain
7injury and their families, for resource facilitator services
8in accordance with section 135.22B, subsection 9, and for
9contracting to enhance brain injury training and recruitment
10of service providers on a statewide basis. Of the amount
11allocated in this paragraph, $95,000 shall be used to fund
121.00 full-time equivalent position to serve as the state brain
13injury services program manager.
14c. Of the funds appropriated in this subsection, $144,000
15shall be used for the public purpose of continuing to contract
16with an existing nationally affiliated organization to provide
17education, client-centered programs, and client and family
18support for people living with epilepsy and their families.
19The amount allocated in this paragraph in excess of $50,000
20shall be matched dollar-for-dollar by the organization
21specified. Funds allocated under this paragraph shall be
22distributed in their entirety for the purpose specified on July
231, 2021.
24d. Of the funds appropriated in this subsection, $809,000
25shall be used for child health specialty clinics.
26e. Of the funds appropriated in this subsection, $384,000
27shall be used by the regional autism assistance program
28established pursuant to section 256.35, and administered by
29the child health specialty clinic located at the university of
30Iowa hospitals and clinics. The funds shall be used to enhance
31interagency collaboration and coordination of educational,
32medical, and other human services for persons with autism,
33their families, and providers of services, including delivering
34regionalized services of care coordination, family navigation,
35and integration of services through the statewide system of
-8-1regional child health specialty clinics and fulfilling other
2requirements as specified in chapter 225D. The university of
3Iowa shall not receive funds allocated under this paragraph for
4indirect costs associated with the regional autism assistance
5program.
6f. Of the funds appropriated in this subsection, $577,000
7shall be used for the comprehensive cancer control program to
8reduce the burden of cancer in Iowa through prevention, early
9detection, effective treatment, and ensuring quality of life.
10Of the funds allocated in this paragraph “f”, $150,000 shall
11be used to support a melanoma research symposium, a melanoma
12biorepository and registry, basic and translational melanoma
13research, and clinical trials.
14g. Of the funds appropriated in this subsection, $97,000
15shall be used for cervical and colon cancer screening, and
16$177,000 shall be used to enhance the capacity of the cervical
17cancer screening program to include provision of recommended
18prevention and early detection measures to a broader range of
19low-income women.
20h. Of the funds appropriated in this subsection, $506,000
21shall be used for the center for congenital and inherited
22disorders.
234. COMMUNITY CAPACITY
24For strengthening the health care delivery system at the
25local level, and for not more than the following full-time
26equivalent positions:
.................................................. $277,319,306
............................................... FTEs2813.00
29a. Of the funds appropriated in this subsection, $95,000
30is allocated for continuation of the child vision screening
31program implemented through the university of Iowa hospitals
32and clinics in collaboration with early childhood Iowa areas.
33The program shall submit a report to the department regarding
34the use of funds allocated under this paragraph “a”. The
35report shall include the objectives and results for the
-9-1program year including the target population and how the funds
2allocated assisted the program in meeting the objectives; the
3number, age, and location within the state of individuals
4served; the type of services provided to the individuals
5served; the distribution of funds based on service provided;
6and the continuing needs of the program.
7b. Of the funds appropriated in this subsection,
8$48,000 shall be used for a grant to a statewide association
9of psychologists, that is affiliated with the American
10psychological association, to be used for continuation of a
11program to rotate intern psychologists in placements that
12serve urban and rural mental health professional shortage
13areas. Once an intern psychologist begins service, the intern
14psychologist may continue serving in the location of the intern
15psychologist’s placement, notwithstanding any change in the
16mental health professional shortage area designation of such
17location. The intern psychologist may also provide services
18via telehealth, to underserved populations, and to Medicaid
19members. For the purposes of this paragraph “b”, “mental
20health professional shortage area” means a geographic area
21in this state that has been designated by the United States
22department of health and human services, health resources and
23services administration, bureau of health professionals, as
24having a shortage of mental health professionals.
25c. Of the funds appropriated in this subsection, the
26following amounts are allocated to be used as follows
27to support the goals of increased access, health system
28integration, and engagement:
29(1) Not less than $1,600,000 is allocated to the Iowa
30prescription drug corporation for continuation of the
31pharmaceutical infrastructure for safety net providers as
32described in 2007 Iowa Acts, chapter 218, section 108, and for
33the prescription drug donation repository program created in
34chapter 135M. Of the amount allocated in this subparagraph,
35$1,000,000 shall be used as one-time funding to support
-10-1program expansion and to implement an automated multi-dose
2prescription packaging system. Funds allocated under this
3subparagraph shall be distributed in their entirety for the
4purpose specified on July 1, 2021.
5(2) Not less than $334,000 is allocated to free clinics and
6free clinics of Iowa for necessary infrastructure, statewide
7coordination, provider recruitment, service delivery, and
8provision of assistance to patients in securing a medical home
9inclusive of oral health care. Funds allocated under this
10subparagraph shall be distributed in their entirety for the
11purpose specified on July 1, 2021.
12(3) Not less than $25,000 is allocated to the Iowa
13association of rural health clinics for necessary
14infrastructure and service delivery transformation. Funds
15allocated under this subparagraph shall be distributed in their
16entirety for the purpose specified on July 1, 2021.
17(4) Not less than $225,000 is allocated to the Polk county
18medical society for continuation of the safety net provider
19patient access to specialty health care initiative as described
20in 2007 Iowa Acts, chapter 218, section 109. Funds allocated
21under this subparagraph shall be distributed in their entirety
22for the purpose specified on July 1, 2021.
23d. Of the funds appropriated in this subsection, $191,000
24is allocated for the purposes of health care and public health
25workforce initiatives.
26e. Of the funds appropriated in this subsection, $96,000
27shall be used for a matching dental education loan repayment
28program to be allocated to a dental nonprofit health service
29corporation to continue to develop the criteria and implement
30the loan repayment program.
31f. Of the funds appropriated in this subsection, $100,000
32shall be used for the purposes of the Iowa donor registry as
33specified in section 142C.18.
34g. Of the funds appropriated in this subsection, $96,000
35shall be used for continuation of a grant to a nationally
-11-1affiliated volunteer eye organization that has an established
2program for children and adults and that is solely dedicated to
3preserving sight and preventing blindness through education,
4nationally certified vision screening and training, and
5community and patient service programs. The contractor shall
6submit a report to the general assembly regarding the use
7of funds allocated under this paragraph “g”. The report
8shall include the objectives and results for the program year
9including the target population and how the funds allocated
10assisted the program in meeting the objectives; the number,
11age, grade level if appropriate, and location within the state
12of individuals served; the type of services provided to the
13individuals served; the distribution of funds based on services
14provided; and the continuing needs of the program.
15h. Of the funds appropriated in this subsection, $2,100,000
16shall be deposited in the medical residency training account
17created in section 135.175, subsection 5, paragraph “a”, and
18is appropriated from the account to the department of public
19health to be used for the purposes of the medical residency
20training state matching grants program as specified in section
21135.176.
22i. Of the funds appropriated in this subsection, $250,000
23shall be used for the public purpose of providing funding to
24Des Moines university to continue a provider education project
25to provide primary care physicians with the training and skills
26necessary to recognize the signs of mental illness in patients.
27j. Of the funds appropriated in this subsection, $600,000
28shall be used for rural psychiatric residencies to support the
29annual creation and training of four psychiatric residents who
30will provide mental health services in underserved areas of
31the state. Notwithstanding section 8.33, moneys that remain
32unencumbered or unobligated at the close of the fiscal year
33shall not revert but shall remain available for expenditure for
34the purposes designated for subsequent fiscal years.
35k. Of the funds appropriated in this subsection, $150,000
-12-1shall be used for psychiatric training to increase access to
2mental health care services by expanding the mental health
3workforce via training of additional physician assistants and
4nurse practitioners.
51. Of the funds appropriated in this subsection, $425,000
6shall be used for the creation of a center of excellence
7program to encourage innovation and collaboration among
8regional health care providers in a rural area based upon the
9results of a regional community needs assessment to transform
10health care delivery in order to provide quality, sustainable
11care that meets the needs of the local communities. An
12applicant for the funds shall specify how the funds will be
13expended to accomplish the goals of the program and shall
14provide a detailed five-year sustainability plan prior to
15being awarded any funding. Following the receipt of funding,
16a recipient shall submit periodic reports as specified by the
17department to the governor and the general assembly regarding
18the recipient’s expenditure of the funds and progress in
19accomplishing the program goals.
205. ESSENTIAL PUBLIC HEALTH SERVICES
21To provide public health services that reduce risks and
22invest in promoting and protecting good health over the
23course of a lifetime with a priority given to older Iowans and
24vulnerable populations:
.................................................. $257,662,464
266. INFECTIOUS DISEASES
27For reducing the incidence and prevalence of communicable
28diseases, and for not more than the following full-time
29equivalent positions:
.................................................. $301,796,206
............................................... FTEs316.00
327. PUBLIC PROTECTION
33For protecting the health and safety of the public through
34establishing standards and enforcing regulations, and for not
35more than the following full-time equivalent positions:
-13-.................................................. $14,466,601
............................................... FTEs2142.00
3a. Of the funds appropriated in this subsection, not more
4than $304,000 shall be credited to the emergency medical
5services fund created in section 135.25. Moneys in the
6emergency medical services fund are appropriated to the
7department to be used for the purposes of the fund.
8b. Of the funds appropriated in this subsection, up
9to $243,000 shall be used for sexual violence prevention
10programming through a statewide organization representing
11programs serving victims of sexual violence through the
12department’s sexual violence prevention program, and for
13continuation of a training program for sexual assault
14response team (SART) members, including representatives of
15law enforcement, victim advocates, prosecutors, and certified
16medical personnel. The amount allocated in this paragraph “b”
17shall not be used to supplant funding administered for other
18sexual violence prevention or victims assistance programs.
19c. Of the funds appropriated in this subsection, up to
20$500,000 shall be used for the state poison control center.
21Pursuant to the directive under 2014 Iowa Acts, chapter
221140, section 102, the federal matching funds available to
23the state poison control center from the department of human
24services under the federal Children’s Health Insurance Program
25Reauthorization Act allotment shall be subject to the federal
26administrative cap rule of 10 percent applicable to funding
27provided under Tit.XXI of the federal Social Security Act and
28included within the department’s calculations of the cap.
29d. Of the funds appropriated in this subsection, up to
30$504,000 shall be used for childhood lead poisoning provisions.
318. RESOURCE MANAGEMENT
32For establishing and sustaining the overall ability of the
33department to deliver services to the public, and for not more
34than the following full-time equivalent positions:
.................................................. $35933,871
-14-............................................... FTEs14.00
29. MISCELLANEOUS PROVISIONS
3The university of Iowa hospitals and clinics under the
4control of the state board of regents shall not receive
5indirect costs from the funds appropriated in this section.
6The university of Iowa hospitals and clinics billings to the
7department shall be on at least a quarterly basis.
8 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
9RECEIPTS FUND. There is appropriated from the sports wagering
10receipts fund created in section 8.57, subsection 6, to the
11department of public health for the fiscal year beginning July
121, 2021, and ending June 30, 2022, the following amount, or
13so much thereof as is necessary, to be used for the purposes
14designated:
15For problem gambling and substance-related disorder
16prevention, treatment, and recovery services, including a
1724-hour helpline, public information resources, professional
18training, youth prevention, and program evaluation:
.................................................. $191,750,000
20DIVISION IV
21DEPARTMENT OF VETERANS AFFAIRS — FY 2021-2022
22 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
23appropriated from the general fund of the state to the
24department of veterans affairs for the fiscal year beginning
25July 1, 2021, and ending June 30, 2022, the following amounts,
26or so much thereof as is necessary, to be used for the purposes
27designated:
281. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
29For salaries, support, maintenance, and miscellaneous
30purposes, and for not more than the following full-time
31equivalent positions:
.................................................. $321,229,763
............................................... FTEs3315.00
342. IOWA VETERANS HOME
35For salaries, support, maintenance, and miscellaneous
-15-1purposes:
.................................................. $27,131,552
3a. The Iowa veterans home billings involving the department
4of human services shall be submitted to the department on at
5least a monthly basis.
6b. The Iowa veterans home expenditure report shall be
7submitted monthly to the general assembly.
8c. The Iowa veterans home shall continue to include in the
9annual discharge report applicant information to provide for
10the collection of demographic information including but not
11limited to the number of individuals applying for admission and
12admitted or denied admittance and the basis for the admission
13or denial; the age, gender, and race of such individuals;
14and the level of care for which such individuals applied for
15admission including residential or nursing level of care.
163. HOME OWNERSHIP ASSISTANCE PROGRAM
17For transfer to the Iowa finance authority for the
18continuation of the home ownership assistance program for
19persons who are or were eligible members of the armed forces of
20the United States, pursuant to section 16.54:
.................................................. $212,000,000
22 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
23FUND STANDING APPROPRIATIONS. Notwithstanding the standing
24appropriation in section 35A.16 for the fiscal year beginning
25July 1, 2021, and ending June 30, 2022, the amount appropriated
26from the general fund of the state pursuant to that section
27for the following designated purposes shall not exceed the
28following amount:
29For the county commissions of veteran affairs fund under
30section 35A.16:
.................................................. $31990,000
32DIVISION V
33DEPARTMENT OF HUMAN SERVICES — FY 2021-2022
34 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
35GRANT. There is appropriated from the fund created in section
-16-18.41 to the department of human services for the fiscal year
2beginning July 1, 2021, and ending June 30, 2022, from moneys
3received under the federal temporary assistance for needy
4families (TANF) block grant pursuant to the federal Personal
5Responsibility and Work Opportunity Reconciliation Act of 1996,
6Pub.L.No.104-193, and successor legislation, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
91. To be credited to the family investment program account
10and used for assistance under the family investment program
11under chapter 239B:
.................................................. $125,002,006
132. To be credited to the family investment program account
14and used for the job opportunities and basic skills (JOBS)
15program and implementing family investment agreements in
16accordance with chapter 239B:
.................................................. $175,412,060
183. To be used for the family development and
19self-sufficiency grant program in accordance with section
20216A.107:
.................................................. $212,888,980
22Notwithstanding section 8.33, moneys appropriated in this
23subsection that remain unencumbered or unobligated at the close
24of the fiscal year shall not revert but shall remain available
25for expenditure for the purposes designated until the close of
26the succeeding fiscal year. However, unless such moneys are
27encumbered or obligated on or before September 30, 2022, the
28moneys shall revert.
294. For field operations:
.................................................. $3031,296,232
315. For general administration:
.................................................. $323,744,000
336. For state child care assistance:
.................................................. $3447,166,826
35a. Of the funds appropriated in this subsection,
-17-1$26,205,412 is transferred to the child care and development
2block grant appropriation made by the Eighty-ninth General
3Assembly, 2021 session, for the federal fiscal year beginning
4October 1, 2021, and ending September 30, 2022. Of this
5amount, $200,000 shall be used for provision of educational
6opportunities to registered child care home providers in order
7to improve services and programs offered by this category
8of providers and to increase the number of providers. The
9department may contract with institutions of higher education
10or child care resource and referral centers to provide
11the educational opportunities. Allowable administrative
12costs under the contracts shall not exceed 5 percent. The
13application for a grant shall not exceed two pages in length.
14b. Any funds appropriated in this subsection remaining
15unallocated shall be used for state child care assistance
16payments for families who are employed including but not
17limited to individuals enrolled in the family investment
18program.
197. For child and family services:
.................................................. $2032,380,654
218. For child abuse prevention grants:
.................................................. $22125,000
239. For pregnancy prevention grants on the condition that
24family planning services are funded:
.................................................. $251,913,203
26Pregnancy prevention grants shall be awarded to programs
27in existence on or before July 1, 2021, if the programs have
28demonstrated positive outcomes. Grants shall be awarded to
29pregnancy prevention programs which are developed after July
301, 2021, if the programs are based on existing models that
31have demonstrated positive outcomes. Grants shall comply with
32the requirements provided in 1997 Iowa Acts, chapter 208,
33section 14, subsections 1 and 2, including the requirement that
34grant programs must emphasize sexual abstinence. Priority in
35the awarding of grants shall be given to programs that serve
-18-1areas of the state which demonstrate the highest percentage of
2unplanned pregnancies of females of childbearing age within the
3geographic area to be served by the grant.
410. For technology needs and other resources necessary to
5meet federal, state, and welfare reform reporting, tracking,
6and case management requirements and other departmental needs:
.................................................. $71,037,186
811. a. Notwithstanding any provision to the contrary,
9including but not limited to requirements in section 8.41 or
10provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the
11receipt and appropriation of federal block grants, federal
12funds from the temporary assistance for needy families block
13grant received by the state and not otherwise appropriated
14in this section and remaining available for the fiscal year
15beginning July 1, 2021, are appropriated to the department of
16human services to the extent as may be necessary to be used in
17the following priority order: the family investment program,
18for state child care assistance program payments for families
19who are employed, and for the family investment program share
20of system costs for eligibility determination and related
21functions. The federal funds appropriated in this paragraph
22“a” shall be expended only after all other funds appropriated
23in subsection 1 for assistance under the family investment
24program, in subsection 6 for state child care assistance, or
25in subsection 10 for technology costs related to the family
26investment program, as applicable, have been expended. For
27the purposes of this subsection, the funds appropriated in
28subsection 6, paragraph “a”, for transfer to the child care
29and development block grant appropriation are considered fully
30expended when the full amount has been transferred.
31b. The department shall, on a quarterly basis, advise the
32general assembly and department of management of the amount of
33funds appropriated in this subsection that was expended in the
34prior quarter.
3512. Of the amounts appropriated in this section,
-19-1$12,962,008 for the fiscal year beginning July 1, 2021, is
2transferred to the appropriation of the federal social services
3block grant made to the department of human services for that
4fiscal year.
513. For continuation of the program providing categorical
6eligibility for the food assistance program as specified
7for the program in the section of this division of this Act
8relating to the family investment program account:
.................................................. $914,236
1014. The department may transfer funds allocated in this
11section to the appropriations made in this division of this Act
12for the same fiscal year for general administration and field
13operations for resources necessary to implement and operate the
14services referred to in this section and those funded in the
15appropriation made in this division of this Act for the same
16fiscal year for the family investment program from the general
17fund of the state.
1815. With the exception of moneys allocated under this
19section for the family development and self-sufficiency grant
20program, to the extent moneys allocated in this section are
21deemed by the department not to be necessary to support the
22purposes for which they are allocated, such moneys may be used
23in the same fiscal year for any other purpose for which funds
24are allocated in this section or in section 8 of this division
25of this Act for the family investment program account. If
26there are conflicting needs, priority shall first be given
27to the family investment program account as specified under
28subsection 1 of this section and used for the purposes of
29assistance under the family investment program in accordance
30with chapter 239B, followed by state child care assistance
31program payments for families who are employed, followed by
32other priorities as specified by the department.
33 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
341. Moneys credited to the family investment program (FIP)
35account for the fiscal year beginning July 1, 2021, and
-20-1ending June 30, 2022, shall be used to provide assistance in
2accordance with chapter 239B.
32. The department may use a portion of the moneys credited
4to the FIP account under this section as necessary for
5salaries, support, maintenance, and miscellaneous purposes.
63. The department may transfer funds allocated in
7subsection 4, excluding the allocation under subsection 4,
8paragraph “b”, to the appropriations made in this division of
9this Act for the same fiscal year for general administration
10and field operations for resources necessary to implement
11and operate the services referred to in this section and
12those funded in the appropriations made in section 7 for the
13temporary assistance for needy families block grant and in
14section 9 for the family investment program from the general
15fund of the state in this division of this Act for the same
16fiscal year.
174. Moneys appropriated in this division of this Act and
18credited to the FIP account for the fiscal year beginning July
191, 2021, and ending June 30, 2022, are allocated as follows:
20a. To be retained by the department of human services to
21be used for coordinating with the department of human rights
22to more effectively serve participants in FIP and other shared
23clients and to meet federal reporting requirements under the
24federal temporary assistance for needy families block grant:
.................................................. $2510,000
26b. To the department of human rights for staffing,
27administration, and implementation of the family development
28and self-sufficiency grant program in accordance with section
29216A.107:
.................................................. $307,192,834
31(1) Of the funds allocated for the family development
32and self-sufficiency grant program in this paragraph “b”,
33not more than 5 percent of the funds shall be used for the
34administration of the grant program.
35(2) The department of human rights may continue to implement
-21-1the family development and self-sufficiency grant program
2statewide during fiscal year 2021-2022.
3(3) The department of human rights may engage in activities
4to strengthen and improve family outcomes measures and
5data collection systems under the family development and
6self-sufficiency grant program.
7c. For the diversion subaccount of the FIP account:
.................................................. $81,293,000
9A portion of the moneys allocated for the diversion
10subaccount may be used for field operations, salaries, data
11management system development, and implementation costs and
12support deemed necessary by the director of human services
13in order to administer the FIP diversion program. To the
14extent moneys allocated in this paragraph “c” are deemed by the
15department not to be necessary to support diversion activities,
16such moneys may be used for other efforts intended to increase
17engagement by family investment program participants in work,
18education, or training activities, or for the purposes of
19assistance under the family investment program in accordance
20with chapter 239B.
21d. For the food assistance employment and training program:
.................................................. $2266,588
23(1) The department shall apply the federal supplemental
24nutrition assistance program (SNAP) employment and training
25state plan in order to maximize to the fullest extent permitted
26by federal law the use of the 50 percent federal reimbursement
27provisions for the claiming of allowable federal reimbursement
28funds from the United States department of agriculture
29pursuant to the federal SNAP employment and training program
30for providing education, employment, and training services
31for eligible food assistance program participants, including
32but not limited to related dependent care and transportation
33expenses.
34(2) The department shall continue the categorical federal
35food assistance program eligibility at 160 percent of the
-22-1federal poverty level and continue to eliminate the asset test
2from eligibility requirements, consistent with federal food
3assistance program requirements. The department shall include
4as many food assistance households as is allowed by federal
5law. The eligibility provisions shall conform to all federal
6requirements including requirements addressing individuals who
7are incarcerated or otherwise ineligible.
8e. For the JOBS program, not more than:
.................................................. $912,018,258
105. Of the child support collections assigned under FIP,
11an amount equal to the federal share of support collections
12shall be credited to the child support recovery appropriation
13made in this division of this Act. Of the remainder of the
14assigned child support collections received by the child
15support recovery unit, a portion shall be credited to the FIP
16account, a portion may be used to increase recoveries, and a
17portion may be used to sustain cash flow in the child support
18payments account. If as a consequence of the appropriations
19and allocations made in this section the resulting amounts
20are insufficient to sustain cash assistance payments and meet
21federal maintenance of effort requirements, the department
22shall seek supplemental funding. If child support collections
23assigned under FIP are greater than estimated or are otherwise
24determined not to be required for maintenance of effort, the
25state share of either amount may be transferred to or retained
26in the child support payments account.
27 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
28is appropriated from the general fund of the state to the
29department of human services for the fiscal year beginning July
301, 2021, and ending June 30, 2022, the following amount, or
31so much thereof as is necessary, to be used for the purpose
32designated:
33To be credited to the family investment program (FIP)
34account and used for family investment program assistance
35under chapter 239B and other costs associated with providing
-23-1needs-based benefits or assistance:
.................................................. $241,003,978
31. Of the funds appropriated in this section, $6,606,198 is
4allocated for the JOBS program.
52. Of the funds appropriated in this section, $4,313,854 is
6allocated for the family development and self-sufficiency grant
7program.
83. a. Notwithstanding section 8.39, for the fiscal
9year beginning July 1, 2021, if necessary to meet federal
10maintenance of effort requirements or to transfer federal
11temporary assistance for needy families block grant funding
12to be used for purposes of the federal social services block
13grant or to meet cash flow needs resulting from delays in
14receiving federal funding or to implement, in accordance with
15this division of this Act, activities currently funded with
16juvenile court services, county, or community moneys and state
17moneys used in combination with such moneys; to comply with
18federal requirements; or to maximize the use of federal funds;
19the department of human services may transfer funds within or
20between any of the appropriations made in this division of this
21Act and appropriations in law for the federal social services
22block grant to the department for the following purposes,
23provided that the combined amount of state and federal
24temporary assistance for needy families block grant funding
25for each appropriation remains the same before and after the
26transfer:
27(1) For the family investment program.
28(2) For state child care assistance.
29(3) For child and family services.
30(4) For field operations.
31(5) For general administration.
32b. This subsection shall not be construed to prohibit the
33use of existing state transfer authority for other purposes.
34The department shall report any transfers made pursuant to this
35subsection to the general assembly.
-24- 14. Of the funds appropriated in this section, $195,000
2shall be used for a contract for tax preparation assistance
3to low-income Iowans to expand the usage of the earned income
4tax credit. The purpose of the contract is to supply this
5assistance to underserved areas of the state. The department
6shall not retain any portion of the allocation under this
7subsection for administrative costs.
85. Of the funds appropriated in this section, $70,000 shall
9be used for the continuation of the parenting program, as
10specified in 441 IAC ch.100, relating to parental obligations,
11in which the child support recovery unit participates, to
12support the efforts of a nonprofit organization committed to
13strengthening the community through youth development, healthy
14living, and social responsibility headquartered in a county
15with a population over 350,000 according to the 2010 certified
16federal census. The funds allocated in this subsection shall
17be used by the recipient organization to develop a larger
18community effort, through public and private partnerships, to
19support a broad-based multi-county parenthood initiative that
20promotes payment of child support obligations, improved family
21relationships, and full-time employment.
226. The department may transfer funds appropriated in this
23section, excluding the allocation in subsection 2 for the
24family development and self-sufficiency grant program, to the
25appropriations made in this division of this Act for general
26administration and field operations as necessary to administer
27this section, section 7 for the temporary assistance for needy
28families block grant, and section 8 for the family investment
29program account.
30 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the following amount, or so much thereof as is
34necessary, to be used for the purposes designated:
35For child support recovery, including salaries, support,
-25-1maintenance, and miscellaneous purposes, and for not more than
2the following full-time equivalent positions:
.................................................. $315,942,885
............................................... FTEs4459.00
51. The department shall expend up to $24,000, including
6federal financial participation, for the fiscal year beginning
7July 1, 2021, for a child support public awareness campaign.
8The department and the office of the attorney general shall
9cooperate in continuation of the campaign. The public
10awareness campaign shall emphasize, through a variety of
11media activities, the importance of maximum involvement of
12both parents in the lives of their children as well as the
13importance of payment of child support obligations.
142. Federal access and visitation grant moneys shall be
15issued directly to private not-for-profit agencies that provide
16services designed to increase compliance with the child access
17provisions of court orders, including but not limited to
18neutral visitation sites and mediation services.
193. The appropriation made to the department for child
20support recovery may be used throughout the fiscal year in the
21manner necessary for purposes of cash flow management, and for
22cash flow management purposes the department may temporarily
23draw more than the amount appropriated, provided the amount
24appropriated is not exceeded at the close of the fiscal year.
25 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
26FY 2021-2022. Any funds remaining in the health care trust
27fund created in section 453A.35A for the fiscal year beginning
28July 1, 2021, and ending June 30, 2022, are appropriated to
29the department of human services to supplement the medical
30assistance program appropriations made in this division of this
31Act, for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
352021-2022. Any funds remaining in the Medicaid fraud fund
-26-1created in section 249A.50 for the fiscal year beginning
2July 1, 2021, and ending June 30, 2022, are appropriated to
3the department of human services to supplement the medical
4assistance appropriations made in this division of this Act,
5for medical assistance reimbursement and associated costs,
6including program administration and costs associated with
7program implementation.
8 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
9general fund of the state to the department of human services
10for the fiscal year beginning July 1, 2021, and ending June 30,
112022, the following amount, or so much thereof as is necessary,
12to be used for the purpose designated:
13For medical assistance program reimbursement and associated
14costs as specifically provided in the reimbursement
15methodologies in effect on June 30, 2021, except as otherwise
16expressly authorized by law, consistent with options under
17federal law and regulations, and contingent upon receipt of
18approval from the office of the governor of reimbursement for
19each abortion performed under the program:
.................................................. $201,503,848,253
211. Iowans support reducing the number of abortions
22performed in our state. Funds appropriated under this section
23shall not be used for abortions, unless otherwise authorized
24under this section.
252. The provisions of this section relating to abortions
26shall also apply to the Iowa health and wellness plan created
27pursuant to chapter 249N.
283. The department shall utilize not more than $60,000 of
29the funds appropriated in this section to continue the AIDS/HIV
30health insurance premium payment program as established in 1992
31Iowa Acts, Second Extraordinary Session, chapter 1001, section
32409, subsection 6. Of the funds allocated in this subsection,
33not more than $5,000 may be expended for administrative
34purposes.
354. Of the funds appropriated in this Act to the department
-27-1of public health for addictive disorders, $950,000 for
2the fiscal year beginning July 1, 2021, is transferred
3to the department of human services for an integrated
4substance-related disorder managed care system. The
5departments of human services and public health shall
6work together to maintain the level of mental health and
7substance-related disorder treatment services provided by the
8managed care contractors. Each department shall take the steps
9necessary to continue the federal waivers as necessary to
10maintain the level of services.
115. The department shall aggressively pursue options for
12providing medical assistance or other assistance to individuals
13with special needs who become ineligible to continue receiving
14services under the early and periodic screening, diagnostic,
15and treatment program under the medical assistance program
16due to becoming 21 years of age who have been approved for
17additional assistance through the department’s exception to
18policy provisions, but who have health care needs in excess
19of the funding available through the exception to policy
20provisions.
216. Of the funds appropriated in this section, up to
22$3,050,082 may be transferred to the field operations or
23general administration appropriations in this division of this
24Act for operational costs associated with Part D of the federal
25Medicare Prescription Drug Improvement and Modernization Act
26of 2003, Pub.L.No.108-173.
277. Of the funds appropriated in this section, up to $442,100
28may be transferred to the appropriation in this division of
29this Act for health program operations to be used for clinical
30assessment services and prior authorization of services.
318. A portion of the funds appropriated in this section may
32be transferred to the appropriations in this division of this
33Act for general administration, health program operations, the
34children’s health insurance program, or field operations to be
35used for the state match cost to comply with the payment error
-28-1rate measurement (PERM) program for both the medical assistance
2and children’s health insurance programs as developed by the
3centers for Medicare and Medicaid services of the United States
4department of health and human services to comply with the
5federal Improper Payments Information Act of 2002, Pub.L.
6No.107-300, and to support other reviews and quality control
7activities to improve the integrity of these programs.
89. Of the funds appropriated in this section, a sufficient
9amount is allocated to supplement the incomes of residents of
10nursing facilities, intermediate care facilities for persons
11with mental illness, and intermediate care facilities for
12persons with an intellectual disability, with incomes of less
13than $50 in the amount necessary for the residents to receive a
14personal needs allowance of $50 per month pursuant to section
15249A.30A.
1610. a. Hospitals that meet the conditions specified
17in subparagraphs (1) and (2) shall either certify public
18expenditures or transfer to the medical assistance program
19an amount equal to provide the nonfederal share for a
20disproportionate share hospital payment in an amount up to the
21hospital-specific limit as approved in the Medicaid state plan.
22The hospitals that meet the conditions specified shall receive
23and retain 100 percent of the total disproportionate share
24hospital payment in an amount up to the hospital-specific limit
25as approved in the Medicaid state plan.
26(1) The hospital qualifies for disproportionate share and
27graduate medical education payments.
28(2) The hospital is an Iowa state-owned hospital with more
29than 500 beds and eight or more distinct residency specialty
30or subspecialty programs recognized by the American college of
31graduate medical education.
32b. Distribution of the disproportionate share payments
33shall be made on a monthly basis. The total amount of
34disproportionate share payments including graduate medical
35education, enhanced disproportionate share, and Iowa
-29-1state-owned teaching hospital payments shall not exceed the
2amount of the state’s allotment under Pub.L.No.102-234.
3In addition, the total amount of all disproportionate
4share payments shall not exceed the hospital-specific
5disproportionate share limits under Pub.L.No.103-66.
611. One hundred percent of the nonfederal share of payments
7to area education agencies that are medical assistance
8providers for medical assistance-covered services provided to
9medical assistance-covered children, shall be made from the
10appropriation made in this section.
1112. A portion of the funds appropriated in this section may
12be transferred to the appropriation in this division of this
13Act for health program operations to be used for administrative
14activities associated with the money follows the person
15demonstration project.
1613. Of the funds appropriated in this section, $349,011
17shall be used for the administration of the health insurance
18premium payment program, including salaries, support,
19maintenance, and miscellaneous purposes.
2014. a. The department may increase the amounts allocated
21for salaries, support, maintenance, and miscellaneous purposes
22associated with the medical assistance program, as necessary,
23to sustain cost management efforts. The department shall
24report any such increase to the general assembly and the
25department of management.
26b. If the savings to the medical assistance program from
27ongoing cost management efforts exceed the associated cost
28for the fiscal year beginning July 1, 2021, the department
29may transfer any savings generated for the fiscal year due
30to medical assistance program cost management efforts to the
31appropriation made in this division of this Act for health
32program operations or general administration to defray the
33costs associated with implementing the efforts.
3415. For the fiscal year beginning July 1, 2021, and ending
35June 30, 2022, the replacement generation tax revenues required
-30-1to be deposited in the property tax relief fund pursuant to
2section 437A.8, subsection 4, paragraph “d”, and section
3437A.15, subsection 3, paragraph “f”, shall instead be credited
4to and supplement the appropriation made in this section and
5used for the allocations made in this section.
616. a. Of the funds appropriated in this section, up
7to $50,000 may be transferred by the department to the
8appropriation made in this division of this Act to the
9department for the same fiscal year for general administration
10to be used for associated administrative expenses and for not
11more than 1.00 full-time equivalent position, in addition to
12those authorized for the same fiscal year, to be assigned to
13implementing the children’s mental health home project.
14b. Of the funds appropriated in this section, up to $400,000
15may be transferred by the department to the appropriation made
16to the department in this division of this Act for the same
17fiscal year for Medicaid program-related general administration
18planning and implementation activities. The funds may be used
19for contracts or for personnel in addition to the amounts
20appropriated for and the positions authorized for general
21administration for the fiscal year.
22c. Of the funds appropriated in this section, up to
23$3,000,000 may be transferred by the department to the
24appropriations made in this division of this Act for the
25same fiscal year for general administration or health
26program operations to be used to support the development
27and implementation of standardized assessment tools for
28persons with mental illness, an intellectual disability, a
29developmental disability, or a brain injury.
3017. Of the funds appropriated in this section, $150,000
31shall be used for lodging expenses associated with care
32provided at the university of Iowa hospitals and clinics for
33patients with cancer whose travel distance is 30 miles or more
34and whose income is at or below 200 percent of the federal
35poverty level as defined by the most recently revised poverty
-31-1income guidelines published by the United States department of
2health and human services. The department of human services
3shall establish the maximum number of overnight stays and the
4maximum rate reimbursed for overnight lodging, which may be
5based on the state employee rate established by the department
6of administrative services. The funds allocated in this
7subsection shall not be used as nonfederal share matching
8funds.
918. Of the funds appropriated in this section, up to
10$3,383,880 shall be used for administration of the state family
11planning services program pursuant to section 217.41B, and
12of this amount, the department may use up to $200,000 for
13administrative expenses.
1419. Of the funds appropriated in this section, $1,545,530
15shall be used and may be transferred to other appropriations
16in this division of this Act as necessary to administer the
17provisions in the division of this Act relating to Medicaid
18program administration.
1920. The department shall comply with the centers for
20Medicare and Medicaid services’ guidance related to Medicaid
21program and children’s health insurance program maintenance
22of effort provisions, including eligibility standards,
23methodologies, procedures, and continuous enrollment, to
24receive the enhanced federal medical assistance percentage
25under section 6008(b) of the federal Families First Coronavirus
26Response Act, Pub.L. No.116-127. The department shall
27utilize and implement all tools, processes, and resources
28available to expediently return to normal eligibility and
29enrollment operations in compliance with federal guidance and
30expectations.
3121. Of the funds appropriated in this section, up to
32$1,031,530 shall be used to implement reductions in the waiting
33list for the children’s mental health home and community-based
34services waiver.
3522. Of the funds appropriated in this section, a sufficient
-32-1amount is allocated to fund up to three full-time equivalent
2positions to support the administrative work associated with
3existing and potential supplemental payment programs.
4 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2021, and ending
7June 30, 2022, the following amount, or so much thereof as is
8necessary, to be used for the purpose designated:
9For health program operations:
.................................................. $1017,831,343
111. The department of inspections and appeals shall
12provide all state matching funds for survey and certification
13activities performed by the department of inspections
14and appeals. The department of human services is solely
15responsible for distributing the federal matching funds for
16such activities.
172. Of the funds appropriated in this section, $50,000 shall
18be used for continuation of home and community-based services
19waiver quality assurance programs, including the review and
20streamlining of processes and policies related to oversight and
21quality management to meet state and federal requirements.
223. Of the amount appropriated in this section, up to
23$200,000 may be transferred to the appropriation for general
24administration in this division of this Act to be used for
25additional full-time equivalent positions in the development
26of key health initiatives such as development and oversight
27of managed care programs and development of health strategies
28targeted toward improved quality and reduced costs in the
29Medicaid program.
304. Of the funds appropriated in this section, $1,000,000
31shall be used for planning and development, in cooperation with
32the department of public health, of a phased-in program to
33provide a dental home for children.
345. a. Of the funds appropriated in this section, $573,000
35shall be credited to the autism support program fund created
-33-1in section 225D.2 to be used for the autism support program
2created in chapter 225D, with the exception of the following
3amount of this allocation which shall be used as follows:
4b. Of the funds allocated in this subsection, $25,000 shall
5be used for the public purpose of continuation of a grant to
6a nonprofit provider of child welfare services that has been
7in existence for more than 115 years, is located in a county
8with a population between 200,000 and 220,000 according to the
92010 federal decennial census, is licensed as a psychiatric
10medical institution for children, and provides school-based
11programming, to be used for support services for children with
12autism spectrum disorder and their families.
13 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
141. There is appropriated from the general fund of the
15state to the department of human services for the fiscal year
16beginning July 1, 2021, and ending June 30, 2022, the following
17amount, or so much thereof as is necessary, to be used for the
18purpose designated:
19For the state supplementary assistance program:
.................................................. $207,349,002
212. The department shall increase the personal needs
22allowance for residents of residential care facilities by the
23same percentage and at the same time as federal supplemental
24security income and federal social security benefits are
25increased due to a recognized increase in the cost of living.
26The department may adopt emergency rules to implement this
27subsection.
283. If during the fiscal year beginning July 1, 2021,
29the department projects that state supplementary assistance
30expenditures for a calendar year will not meet the federal
31pass-through requirement specified in Tit.XVI of the federal
32Social Security Act, section 1618, as codified in 42 U.S.C.
33§1382g, the department may take actions including but not
34limited to increasing the personal needs allowance for
35residential care facility residents and making programmatic
-34-1adjustments or upward adjustments of the residential care
2facility or in-home health-related care reimbursement rates
3prescribed in this division of this Act to ensure that federal
4requirements are met. In addition, the department may make
5other programmatic and rate adjustments necessary to remain
6within the amount appropriated in this section while ensuring
7compliance with federal requirements. The department may adopt
8emergency rules to implement the provisions of this subsection.
94. Notwithstanding section 8.33, moneys appropriated
10in this section that remain unencumbered or unobligated
11at the close of the fiscal year shall not revert but
12shall remain available for expenditure for the purposes
13designated, including for liability amounts associated with the
14supplemental nutrition assistance program payment error rate,
15until the close of the succeeding fiscal year.
16 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2021, and ending June 30, 2022, the following
20amount, or so much thereof as is necessary, to be used for the
21purpose designated:
22For maintenance of the healthy and well kids in Iowa (hawk-i)
23program pursuant to chapter 514I, including supplemental dental
24services, for receipt of federal financial participation under
25Tit.XXI of the federal Social Security Act, which creates the
26children’s health insurance program:
.................................................. $2737,957,643
282. Of the funds appropriated in this section, $149,189 is
29allocated for continuation of the contract for outreach with
30the department of public health.
313. A portion of the funds appropriated in this section may
32be transferred to the appropriations made in this division of
33this Act for field operations or health program operations to
34be used for the integration of hawk-i program eligibility,
35payment, and administrative functions under the purview of
-35-1the department of human services, including for the Medicaid
2management information system upgrade.
3 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2021, and ending
6June 30, 2022, the following amount, or so much thereof as is
7necessary, to be used for the purpose designated:
8For child care programs:
.................................................. $940,816,931
101. Of the funds appropriated in this section, $34,966,931
11shall be used for state child care assistance in accordance
12with section 237A.13.
132. Nothing in this section shall be construed or is
14intended as or shall imply a grant of entitlement for services
15to persons who are eligible for assistance due to an income
16level consistent with the waiting list requirements of section
17237A.13. Any state obligation to provide services pursuant to
18this section is limited to the extent of the funds appropriated
19in this section.
203. A list of the registered and licensed child care
21facilities operating in the area served by a child care
22resource and referral service shall be made available to the
23families receiving state child care assistance in that area.
244. Of the funds appropriated in this section, $5,850,000
25shall be credited to the early childhood programs grants
26account in the early childhood Iowa fund created in section
27256I.11. The moneys shall be distributed for funding of
28community-based early childhood programs targeted to children
29from birth through five years of age developed by early
30childhood Iowa areas in accordance with approved community
31plans as provided in section 256I.8.
325. The department may use any of the funds appropriated
33in this section as a match to obtain federal funds for use in
34expanding child care assistance and related programs. For
35the purpose of expenditures of state and federal child care
-36-1funding, funds shall be considered obligated at the time
2expenditures are projected or are allocated to the department’s
3service areas. Projections shall be based on current and
4projected caseload growth, current and projected provider
5rates, staffing requirements for eligibility determination
6and management of program requirements including data systems
7management, staffing requirements for administration of the
8program, contractual and grant obligations and any transfers
9to other state agencies, and obligations for decategorization
10or innovation projects.
116. A portion of the state match for the federal child care
12and development block grant shall be provided as necessary to
13meet federal matching funds requirements through the state
14general fund appropriation made for child development grants
15and other programs for at-risk children in section 279.51.
167. If a uniform reduction ordered by the governor under
17section 8.31 or other operation of law, transfer, or federal
18funding reduction reduces the appropriation made in this
19section for the fiscal year, the percentage reduction in the
20amount paid out to or on behalf of the families participating
21in the state child care assistance program shall be equal to or
22less than the percentage reduction made for any other purpose
23payable from the appropriation made in this section and the
24federal funding relating to it. The percentage reduction to
25the other allocations made in this section shall be the same as
26the uniform reduction ordered by the governor or the percentage
27change of the federal funding reduction, as applicable. If
28there is an unanticipated increase in federal funding provided
29for state child care services, the entire amount of the
30increase, except as necessary to meet federal requirements
31including quality set asides, shall be used for state child
32care assistance payments. If the appropriations made for
33purposes of the state child care assistance program for the
34fiscal year are determined to be insufficient, it is the intent
35of the general assembly to appropriate sufficient funding for
-37-1the fiscal year in order to avoid establishment of waiting list
2requirements.
38. Notwithstanding section 8.33, moneys advanced for
4purposes of the programs developed by early childhood Iowa
5areas, advanced for purposes of wraparound child care, or
6received from the federal appropriations made for the purposes
7of this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert to any fund but shall
9remain available for expenditure for the purposes designated
10until the close of the succeeding fiscal year.
11 Sec. 18. JUVENILE INSTITUTION. There is appropriated
12from the general fund of the state to the department of human
13services for the fiscal year beginning July 1, 2021, and ending
14June 30, 2022, the following amounts, or so much thereof as is
15necessary, to be used for the purposes designated:
161. a. For operation of the state training school at Eldora
17and for salaries, support, maintenance, and miscellaneous
18purposes, and for not more than the following full-time
19equivalent positions:
.................................................. $2017,397,068
............................................... FTEs21207.00
22b. Of the funds appropriated in this subsection, $91,000
23shall be used for distribution to licensed classroom teachers
24at this and other institutions under the control of the
25department of human services based upon the average student
26yearly enrollment at each institution as determined by the
27department.
282. A portion of the moneys appropriated in this section
29shall be used by the state training school at Eldora for
30grants for adolescent pregnancy prevention activities at the
31institution in the fiscal year beginning July 1, 2021.
323. Of the funds appropriated in this subsection, $212,000
33shall be used by the state training school at Eldora for a
34substance use disorder treatment program at the institution for
35the fiscal year beginning July 1, 2021.
-38- 14. Notwithstanding section 8.33, moneys appropriated in
2this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert but shall remain
4available for expenditure for the purposes designated until the
5close of the succeeding fiscal year.
6 Sec. 19. CHILD AND FAMILY SERVICES.
71. There is appropriated from the general fund of the
8state to the department of human services for the fiscal year
9beginning July 1, 2021, and ending June 30, 2022, the following
10amount, or so much thereof as is necessary, to be used for the
11purpose designated:
12For child and family services:
.................................................. $1389,071,930
142. The department may transfer funds appropriated in this
15section as necessary to pay the nonfederal costs of services
16reimbursed under the medical assistance program, state child
17care assistance program, or the family investment program which
18are provided to children who would otherwise receive services
19paid under the appropriation in this section. The department
20may transfer funds appropriated in this section to the
21appropriations made in this division of this Act for general
22administration and for field operations for resources necessary
23to implement and operate the services funded in this section.
243. a. Of the funds appropriated in this section, up to
25$31,500,000 is allocated as the statewide expenditure target
26under section 232.143 for group foster care maintenance and
27services. If the department projects that such expenditures
28for the fiscal year will be less than the target amount
29allocated in this paragraph “a”, the department may reallocate
30the excess to provide additional funding for family foster
31care, independent living, family-centered services, shelter
32care, or the child welfare emergency services addressed with
33the allocation for shelter care.
34b. If at any time after September 30, 2021, annualization
35of a service area’s current expenditures indicates a service
-39-1area is at risk of exceeding its group foster care expenditure
2target under section 232.143 by more than 5 percent, the
3department and juvenile court services shall examine all
4group foster care placements in that service area in order to
5identify those which might be appropriate for termination.
6In addition, any aftercare services believed to be needed
7for the children whose placements may be terminated shall be
8identified. The department and juvenile court services shall
9initiate action to set dispositional review hearings for the
10placements identified. In such a dispositional review hearing,
11the juvenile court shall determine whether needed aftercare
12services are available and whether termination of the placement
13is in the best interest of the child and the community.
144. In accordance with the provisions of section 232.188,
15the department shall continue the child welfare and juvenile
16justice funding initiative during fiscal year 2021-2022. Of
17the funds appropriated in this section, $1,717,000 is allocated
18specifically for expenditure for fiscal year 2021-2022 through
19the decategorization services funding pools and governance
20boards established pursuant to section 232.188.
215. A portion of the funds appropriated in this section
22may be used for emergency family assistance to provide other
23resources required for a family participating in a family
24preservation or reunification project or successor project to
25stay together or to be reunified.
266. Of the funds appropriated in this section, a sufficient
27amount is allocated for shelter care and the child welfare
28emergency services contracting implemented to provide for or
29prevent the need for shelter care.
307. Federal funds received by the state during the fiscal
31year beginning July 1, 2021, as the result of the expenditure
32of state funds appropriated during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for services and purposes provided for under this section.
-40-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated at
3the close of the fiscal year shall not revert to any fund but
4shall remain available for the purposes designated until the
5close of the succeeding fiscal year.
68. a. Of the funds appropriated in this section, up to
7$3,290,000 is allocated for the payment of the expenses of
8court-ordered services provided to juveniles who are under the
9supervision of juvenile court services, which expenses are a
10charge upon the state pursuant to section 232.141, subsection
114. Of the amount allocated in this paragraph “a”, up to
12$1,556,000 shall be made available to provide school-based
13supervision of children adjudicated under chapter 232, of which
14not more than $15,000 may be used for the purpose of training.
15A portion of the cost of each school-based liaison officer
16shall be paid by the school district or other funding source as
17approved by the chief juvenile court officer.
18b. Of the funds appropriated in this section, up to $748,000
19is allocated for the payment of the expenses of court-ordered
20services provided to children who are under the supervision
21of the department, which expenses are a charge upon the state
22pursuant to section 232.141, subsection 4.
23c. Notwithstanding section 232.141 or any other provision
24of law to the contrary, the amounts allocated in this
25subsection shall be distributed to the judicial districts
26as determined by the state court administrator and to the
27department’s service areas as determined by the administrator
28of the department of human services’ division of child and
29family services. The state court administrator and the
30division administrator shall make the determination of the
31distribution amounts on or before June 15, 2021.
32d. Notwithstanding chapter 232 or any other provision of
33law to the contrary, a district or juvenile court shall not
34order any service which is a charge upon the state pursuant
35to section 232.141 if there are insufficient court-ordered
-41-1services funds available in the district court or departmental
2service area distribution amounts to pay for the service. The
3chief juvenile court officer and the departmental service area
4manager shall encourage use of the funds allocated in this
5subsection such that there are sufficient funds to pay for
6all court-related services during the entire year. The chief
7juvenile court officers and departmental service area managers
8shall attempt to anticipate potential surpluses and shortfalls
9in the distribution amounts and shall cooperatively request the
10state court administrator or division administrator to transfer
11funds between the judicial districts’ or departmental service
12areas’ distribution amounts as prudent.
13e. Notwithstanding any provision of law to the contrary,
14a district or juvenile court shall not order a county to pay
15for any service provided to a juvenile pursuant to an order
16entered under chapter 232 which is a charge upon the state
17under section 232.141, subsection 4.
18f. Of the funds allocated in this subsection, not more than
19$83,000 may be used by the judicial branch for administration
20of the requirements under this subsection.
21g. Of the funds allocated in this subsection, $17,000
22shall be used by the department of human services to support
23the interstate commission for juveniles in accordance with
24the interstate compact for juveniles as provided in section
25232.173.
269. Of the funds appropriated in this section, $12,253,000 is
27allocated for juvenile delinquent graduated sanctions services.
28Any state funds saved as a result of efforts by juvenile court
29services to earn a federal Tit.IV-E match for juvenile court
30services administration may be used for the juvenile delinquent
31graduated sanctions services.
3210. Of the funds appropriated in this section, $1,658,000 is
33transferred to the department of public health to be used for
34the child protection center grant program for child protection
35centers located in Iowa in accordance with section 135.118.
-42-1The grant amounts under the program shall be equalized so that
2each center receives a uniform base amount of $245,000, and so
3that the remaining funds are awarded through a funding formula
4based upon the volume of children served. To increase access
5to child protection center services for children in rural
6areas, the funding formula for the awarding of the remaining
7funds shall provide for the awarding of an enhanced amount to
8eligible grantees to develop and maintain satellite centers in
9underserved regions of the state.
1011. Of the funds appropriated in this section, $4,025,000 is
11allocated for the preparation for adult living program pursuant
12to section 234.46.
1312. Of the funds appropriated in this section, $227,000
14shall be used for the public purpose of continuing a grant to a
15nonprofit human services organization, providing services to
16individuals and families in multiple locations in southwest
17Iowa and Nebraska for support of a project providing immediate,
18sensitive support and forensic interviews, medical exams, needs
19assessments, and referrals for victims of child abuse and their
20nonoffending family members.
2113. Of the funds appropriated in this section, $300,000
22is allocated for the foster care youth council approach of
23providing a support network to children placed in foster care.
2414. Of the funds appropriated in this section, $202,000 is
25allocated for use pursuant to section 235A.1 for continuation
26of the initiative to address child sexual abuse implemented
27pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2821.
2915. Of the funds appropriated in this section, $630,000 is
30allocated for the community partnership for child protection
31sites.
3216. Of the funds appropriated in this section, $371,000
33is allocated for the department’s minority youth and family
34projects under the redesign of the child welfare system.
3517. Of the funds appropriated in this section, $851,000
-43-1is allocated for funding of the community circle of care
2collaboration for children and youth in northeast Iowa.
318. Of the funds appropriated in this section, at least
4$147,000 shall be used for the continuation of the child
5welfare provider training academy, a collaboration between the
6coalition for family and children’s services in Iowa and the
7department.
819. Of the funds appropriated in this section, $211,000
9shall be used for continuation of the central Iowa system of
10care program grant for the purposes of funding community-based
11services and other supports with a system of care approach for
12children with serious emotional disturbance and their families
13through a nonprofit provider that is located in a county
14with a population of more than 420,000 but less than 450,000
15according to the 2010 certified federal census, is licensed
16as a psychiatric medical institution for children, and was a
17system of care grantee prior to July 1, 2021.
1820. Of the funds appropriated in this section, $235,000
19shall be used for the public purpose of the continuation
20and expansion of a system of care program grant implemented
21in Cerro Gordo and Linn counties to utilize a comprehensive
22and long-term approach for helping children and families by
23addressing the key areas in a child’s life of childhood basic
24needs, education and work, family, and community.
2521. Of the funds appropriated in this section, $110,000
26shall be used for the public purpose of funding community-based
27services and other supports with a system of care approach
28for children with a serious emotional disturbance and their
29families through a nonprofit provider of child welfare services
30that has been in existence for more than 115 years, is located
31in a county with a population of more than 200,000 but less
32than 220,000 according to the 2010 certified federal census, is
33licensed as a psychiatric medical institution for children, and
34was a system of care grantee prior to July 1, 2021.
3522. If a separate funding source is identified that reduces
-44-1the need for state funds within an allocation under this
2section, the allocated state funds may be redistributed to
3other allocations under this section for the same fiscal year.
423. Of the funds appropriated in this section, a portion may
5be used for family-centered services for purposes of complying
6with the federal Family First Prevention Services Act of 2018,
7Pub.L. No.115-123, and successor legislation.
8 Sec. 20. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2021, and ending June 30, 2022, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and related costs and for
15other services provided for under paragraph “b”, subparagraph
16(2):
.................................................. $1740,596,007
18b. (1) Of the funds appropriated in this section, a
19sufficient amount is allocated for adoption subsidy payments
20and related costs.
21(2) Any funds appropriated in this section remaining after
22the allocation under subparagraph (1) are designated and
23allocated as state savings resulting from implementation of
24the federal Fostering Connections to Success and Increasing
25Adoptions Act of 2008, Pub.L. No.110-351, and successor
26legislation, as determined in accordance with 42 U.S.C.
27§673(a)(8), and shall be used for post-adoption services and
28for other purposes allowed under these federal laws, Tit.IV-B
29or Tit.IV-E of the federal Social Security Act.
30(a) The department of human services may transfer funds
31allocated in this subparagraph (2) to the appropriation for
32child and family services in this division of this Act for the
33purposes designated in this subparagraph (2).
34(b) Notwithstanding section 8.33, moneys allocated
35under this subparagraph (2) shall not revert to any fund but
-45-1shall remain available for the purposes designated in this
2subparagraph (2) until expended.
32. The department may transfer funds appropriated in
4this section to the appropriation made in this division of
5this Act for general administration for costs paid from the
6appropriation relating to adoption subsidy.
73. Federal funds received by the state during the
8fiscal year beginning July 1, 2021, as the result of the
9expenditure of state funds during a previous state fiscal
10year for a service or activity funded under this section are
11appropriated to the department to be used as additional funding
12for the services and activities funded under this section.
13Notwithstanding section 8.33, moneys received in accordance
14with this subsection that remain unencumbered or unobligated
15at the close of the fiscal year shall not revert to any fund
16but shall remain available for expenditure for the purposes
17designated until the close of the succeeding fiscal year.
18 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
19in the juvenile detention home fund created in section 232.142
20during the fiscal year beginning July 1, 2021, and ending June
2130, 2022, are appropriated to the department of human services
22for the fiscal year beginning July 1, 2021, and ending June 30,
232022, for distribution of an amount equal to a percentage of
24the costs of the establishment, improvement, operation, and
25maintenance of county or multicounty juvenile detention homes
26in the fiscal year beginning July 1, 2020. Moneys appropriated
27for distribution in accordance with this section shall be
28allocated among eligible detention homes, prorated on the basis
29of an eligible detention home’s proportion of the costs of all
30eligible detention homes in the fiscal year beginning July
311, 2020. The percentage figure shall be determined by the
32department based on the amount available for distribution for
33the fund. Notwithstanding section 232.142, subsection 3, the
34financial aid payable by the state under that provision for the
35fiscal year beginning July 1, 2021, shall be limited to the
-46-1amount appropriated for the purposes of this section.
2 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2021, and ending June 30, 2022, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For the family support subsidy program subject to the
9enrollment restrictions in section 225C.37, subsection 3:
.................................................. $10949,282
112. At least $899,291 of the moneys appropriated in this
12section is transferred to the department of public health for
13the family support center component of the comprehensive family
14support program under chapter 225C, subchapter V.
153. If at any time during the fiscal year, the amount of
16funding available for the family support subsidy program
17is reduced from the amount initially used to establish the
18figure for the number of family members for whom a subsidy
19is to be provided at any one time during the fiscal year,
20notwithstanding section 225C.38, subsection 2, the department
21shall revise the figure as necessary to conform to the amount
22of funding available.
23 Sec. 23. CONNER DECREE. There is appropriated from the
24general fund of the state to the department of human services
25for the fiscal year beginning July 1, 2021, and ending June 30,
262022, the following amount, or so much thereof as is necessary,
27to be used for the purpose designated:
28For building community capacity through the coordination
29and provision of training opportunities in accordance with the
30consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
31Iowa, July 14, 1994):
.................................................. $3233,632
33 Sec. 24. MENTAL HEALTH INSTITUTES.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-47-1beginning July 1, 2021, and ending June 30, 2022, the following
2amounts, or so much thereof as is necessary, to be used for the
3purposes designated:
4a. For operation of the state mental health institute at
5Cherokee as required by chapters 218 and 226 for salaries,
6support, maintenance, and miscellaneous purposes, and for not
7more than the following full-time equivalent positions:
.................................................. $815,457,597
............................................... FTEs9169.00
10b. For operation of the state mental health institute at
11Independence as required by chapters 218 and 226 for salaries,
12support, maintenance, and miscellaneous purposes, and for not
13more than the following full-time equivalent positions:
.................................................. $1419,652,379
............................................... FTEs15208.00
162. a. Notwithstanding sections 218.78 and 249A.11, any
17revenue received from the state mental health institute at
18Cherokee or the state mental health institute at Independence
19pursuant to 42 C.F.R§438.6(e) may be retained and expended by
20the mental health institute.
21b. Notwithstanding sections 218.78 and 249A.11, any
22COVID-19 related funding received through federal funding
23sources by the state mental health institute at Cherokee or the
24state mental health institute at Independence may be retained
25and expended by the mental health institute.
263. Notwithstanding any provision of law to the contrary,
27a Medicaid member residing at the state mental health
28institute at Cherokee or the state mental health institute
29at Independence shall retain Medicaid eligibility during
30the period of the Medicaid member’s stay for which federal
31financial participation is available.
324. Notwithstanding section 8.33, moneys appropriated in
33this section that remain unencumbered or unobligated at the
34close of the fiscal year shall not revert but shall remain
35available for expenditure for the purposes designated until the
-48-1close of the succeeding fiscal year.
2 Sec. 25. STATE RESOURCE CENTERS.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2021, and ending June 30, 2022, the following
6amounts, or so much thereof as is necessary, to be used for the
7purposes designated:
8a. For the state resource center at Glenwood for salaries,
9support, maintenance, and miscellaneous purposes:
.................................................. $1014,802,873
11b. For the state resource center at Woodward for salaries,
12support, maintenance, and miscellaneous purposes:
.................................................. $1312,237,937
142. The department may continue to bill for state resource
15center services utilizing a scope of services approach used for
16private providers of intermediate care facilities for persons
17with an intellectual disability services, in a manner which
18does not shift costs between the medical assistance program,
19counties, or other sources of funding for the state resource
20centers.
213. The state resource centers may expand the time-limited
22assessment and respite services during the fiscal year.
234. If the department’s administration and the department
24of management concur with a finding by a state resource
25center’s superintendent that projected revenues can reasonably
26be expected to pay the salary and support costs for a new
27employee position, or that such costs for adding a particular
28number of new positions for the fiscal year would be less
29than the overtime costs if new positions would not be added,
30the superintendent may add the new position or positions. If
31the vacant positions available to a resource center do not
32include the position classification desired to be filled, the
33state resource center’s superintendent may reclassify any
34vacant position as necessary to fill the desired position. The
35superintendents of the state resource centers may, by mutual
-49-1agreement, pool vacant positions and position classifications
2during the course of the fiscal year in order to assist one
3another in filling necessary positions.
45. If existing capacity limitations are reached in
5operating units, a waiting list is in effect for a service or
6a special need for which a payment source or other funding
7is available for the service or to address the special need,
8and facilities for the service or to address the special need
9can be provided within the available payment source or other
10funding, the superintendent of a state resource center may
11authorize opening not more than two units or other facilities
12and begin implementing the service or addressing the special
13need during fiscal year 2021-2022.
146. Notwithstanding section 8.33, and notwithstanding
15the amount limitation specified in section 222.92, moneys
16appropriated in this section that remain unencumbered or
17unobligated at the close of the fiscal year shall not revert
18but shall remain available for expenditure for the purposes
19designated until the close of the succeeding fiscal year.
20 Sec. 26. SEXUALLY VIOLENT PREDATORS.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2021, and ending June 30, 2022, the following
24amount, or so much thereof as is necessary, to be used for the
25purpose designated:
26For costs associated with the commitment and treatment of
27sexually violent predators in the unit located at the state
28mental health institute at Cherokee, including costs of legal
29services and other associated costs, including salaries,
30support, maintenance, and miscellaneous purposes, and for not
31more than the following full-time equivalent positions:
.................................................. $3213,643,727
............................................... FTEs33139.00
342. Unless specifically prohibited by law, if the amount
35charged provides for recoupment of at least the entire amount
-50-1of direct and indirect costs, the department of human services
2may contract with other states to provide care and treatment
3of persons placed by the other states at the unit for sexually
4violent predators at Cherokee. The moneys received under
5such a contract shall be considered to be repayment receipts
6and used for the purposes of the appropriation made in this
7section.
83. Notwithstanding section 8.33, moneys appropriated in
9this section that remain unencumbered or unobligated at the
10close of the fiscal year shall not revert but shall remain
11available for expenditure for the purposes designated until the
12close of the succeeding fiscal year.
13 Sec. 27. FIELD OPERATIONS.
141. There is appropriated from the general fund of the
15state to the department of human services for the fiscal year
16beginning July 1, 2021, and ending June 30, 2022, the following
17amount, or so much thereof as is necessary, to be used for the
18purposes designated:
19For field operations, including salaries, support,
20maintenance, and miscellaneous purposes, and for not more than
21the following full-time equivalent positions:
.................................................. $2260,596,667
............................................... FTEs231,539.00
242. Priority in filling full-time equivalent positions
25shall be given to those positions related to child protection
26services and eligibility determination for low-income families.
27 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
28from the general fund of the state to the department of human
29services for the fiscal year beginning July 1, 2021, and ending
30June 30, 2022, the following amount, or so much thereof as is
31necessary, to be used for the purpose designated:
32For general administration, including salaries, support,
33maintenance, and miscellaneous purposes, and for not more than
34the following full-time equivalent positions:
.................................................. $3515,342,189
-51-............................................... FTEs1294.00
21. The department shall report at least monthly to the
3general assembly concerning the department’s operational and
4program expenditures.
52. Of the funds appropriated in this section, $150,000 shall
6be used for the provision of a program to provide technical
7assistance, support, and consultation to providers of home and
8community-based services under the medical assistance program.
93. Of the funds appropriated in this section, $50,000
10is transferred to the Iowa finance authority to be used
11for administrative support of the council on homelessness
12established in section 16.2D and for the council to fulfill its
13duties in addressing and reducing homelessness in the state.
144. Of the funds appropriated in this section, $200,000 shall
15be transferred to and deposited in the administrative fund of
16the Iowa ABLE savings plan trust created in section 12I.4, to
17be used for implementation and administration activities of the
18Iowa ABLE savings plan trust.
195. Of the funds appropriated in this section, $200,000 is
20transferred to the economic development authority for the Iowa
21commission on volunteer services to continue to be used for the
22RefugeeRISE AmeriCorps program established under section 15H.8
23for member recruitment and training to improve the economic
24well-being and health of economically disadvantaged refugees in
25local communities across Iowa. Funds transferred may be used
26to supplement federal funds under federal regulations.
276. Of the funds appropriated in this section, up to $300,000
28shall be used as follows:
29a. To fund not more than one full-time equivalent position
30to address the department’s responsibility to support the work
31of the children’s behavioral health system state board and
32implementation of the services required pursuant to section
33331.397.
34b. To support the cost of establishing and implementing new
35or additional services required pursuant to sections 331.397
-52-1and 331.397A.
2c. Of the amount allocated, $32,000 shall be transferred
3to the department of public health to support the costs of
4establishing and implementing new or additional services
5required pursuant to sections 331.397 and 331.397A.
67. Of the funds appropriated in this section, $800,000 shall
7be used for the renovation and construction of certain nursing
8facilities, consistent with the provisions of chapter 249K.
9 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2021, and ending
12June 30, 2022, the following amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For salaries, support, maintenance, and miscellaneous
15purposes at facilities under the purview of the department of
16human services:
.................................................. $172,879,274
18 Sec. 30. VOLUNTEERS. There is appropriated from the general
19fund of the state to the department of human services for the
20fiscal year beginning July 1, 2021, and ending June 30, 2022,
21the following amount, or so much thereof as is necessary, to be
22used for the purpose designated:
23For development and coordination of volunteer services:
.................................................. $2484,686
25 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
26ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
27DEPARTMENT OF HUMAN SERVICES.
281. a. (1) (a) Notwithstanding any provision of law to
29the contrary, for the fiscal year beginning July 1, 2021, the
30department shall not rebase case-mix nursing facility rates,
31but shall instead reimburse case-mix nursing facilities by
32adjusting the nursing facility case-mix adjusted rates that
33were effective July 1, 2019, using the mid-points of each of
34the most recent cost reports submitted by the nursing facility
35for the period ending on or before December 31, 2018, and
-53-1inflating these costs forward applying the inflation factor as
2determined using the latest available quarterly publication of
3the HCFA/SNF index, to the extent possible within the state
4funding, including the $19,080,860 provided for this purpose.
5(b) For the fiscal year beginning July 1, 2021, non-case-mix
6and special population nursing facilities shall be reimbursed
7in accordance with the methodology in effect on June 30 of the
8prior fiscal year.
9(c) For managed care claims, the department of human
10services shall adjust the payment rate floor for nursing
11facilities, annually, to maintain a rate floor that is no
12lower than the Medicaid fee-for-service case-mix adjusted rate
13calculated in accordance with subparagraph division (a) and
14441 IAC 81.6. The department shall then calculate adjusted
15reimbursement rates, including but not limited to add-on
16payments, annually, and shall notify Medicaid managed care
17organizations of the adjusted reimbursement rates within 30
18days of determining the adjusted reimbursement rates. Any
19adjustment of reimbursement rates under this subparagraph
20division shall be budget neutral to the state budget.
21(d) For the fiscal year beginning July 1, 2021, Medicaid
22managed care long-term services and supports capitation rates
23shall be adjusted to reflect the case-mix adjusted rates
24specified pursuant to subparagraph division (a) for the patient
25populations residing in Medicaid-certified nursing facilities.
26(2) Medicaid managed care organizations shall adjust
27facility-specific rates based upon payment rate listings issued
28by the department. The rate adjustments shall be applied
29prospectively from the effective date of the rate letter issued
30by the department.
31b. (1) For the fiscal year beginning July 1, 2021,
32contingent upon implementation of the contractual agreements
33with Medicaid managed care organizations as described pursuant
34to subparagraph (2), the department shall establish the
35fee-for-service pharmacy dispensing fee reimbursement at
-54-1$10.38 per prescription, until a cost of dispensing survey is
2completed. The actual dispensing fee shall be determined by
3a cost of dispensing survey performed by the department and
4required to be completed by all medical assistance program
5participating pharmacies every two years. A change in the
6dispensing fee shall become effective following federal
7approval of the Medicaid state plan.
8(2) The department shall amend Medicaid managed care
9organization contracts to authorize establishment of a managed
10care pharmacy dispensing fee reimbursement in accordance with
11either of the following:
12(a) The established fee-for-service pharmacy dispensing
13fee reimbursement per prescription as specified pursuant to
14subparagraph (1).
15(b) A dispensing fee determined contractually by mutual
16agreement between the managed care organization and a
17participating pharmacy with more than thirty locations in
18the state and headquarters located outside the state, not to
19exceed the established fee-for-service pharmacy dispensing
20fee reimbursement per prescription as specified pursuant to
21subparagraph (1).
22(3) The department shall utilize an average acquisition
23cost reimbursement methodology for all drugs covered under the
24medical assistance program in accordance with 2012 Iowa Acts,
25chapter 1133, section 33.
26c. (1) For the fiscal year beginning July 1, 2021,
27reimbursement rates for outpatient hospital services shall
28remain at the rates in effect on June 30, 2021, subject to
29Medicaid program upper payment limit rules, and adjusted
30as necessary to maintain expenditures within the amount
31appropriated to the department for this purpose for the fiscal
32year.
33(2) For the fiscal year beginning July 1, 2021,
34reimbursement rates for inpatient hospital services shall
35be rebased effective October 1, 2021, subject to Medicaid
-55-1program upper payment limit rules, and adjusted as necessary
2to maintain expenditures within the amount appropriated to the
3department for this purpose for the fiscal year.
4(3) For the fiscal year beginning July 1, 2021, under
5both fee-for-service and managed care administration of
6the Medicaid program, critical access hospitals shall be
7reimbursed for inpatient and outpatient services based on the
8hospital-specific critical access hospital cost adjustment
9factor methodology utilizing the most recent and complete cost
10reporting period as applied prospectively within the funds
11appropriated for such purpose for the fiscal year.
12(4) For the fiscal year beginning July 1, 2021, the graduate
13medical education and disproportionate share hospital fund
14shall remain at the amount in effect on June 30, 2021, except
15that the portion of the fund attributable to graduate medical
16education shall be reduced in an amount that reflects the
17elimination of graduate medical education payments made to
18out-of-state hospitals.
19(5) In order to ensure the efficient use of limited state
20funds in procuring health care services for low-income Iowans,
21funds appropriated in this Act for hospital services shall
22not be used for activities which would be excluded from a
23determination of reasonable costs under the federal Medicare
24program pursuant to 42 U.S.C.§1395x(v)(1)(N).
25d. For the fiscal year beginning July 1, 2021, reimbursement
26rates for hospices and acute psychiatric hospitals shall be
27increased in accordance with increases under the federal
28Medicare program or as supported by their Medicare audited
29costs.
30e. For the fiscal year beginning July 1, 2021, independent
31laboratories and rehabilitation agencies shall be reimbursed
32using the same methodology in effect on June 30, 2021.
33f. (1) For the fiscal year beginning July 1, 2021,
34reimbursement rates for home health agencies shall continue to
35be based on the Medicare low utilization payment adjustment
-56-1(LUPA) methodology with state geographic wage adjustments and
2shall be adjusted to increase the rates to the extent possible
3within the state funding, including the $2,000,000 appropriated
4for this purpose. The department shall continue to update the
5rates every two years to reflect the most recent Medicare LUPA
6rates.
7(2) For the fiscal year beginning July 1, 2021, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2021.
12g. For the fiscal year beginning July 1, 2021, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2021, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2021.
20i. (1) For the fiscal year beginning July 1, 2021,
21reimbursement rates for non-state-owned psychiatric medical
22institutions for children shall be increased to the extent
23possible within the $3,900,000 appropriated for this purpose.
24(2) As a condition of participation in the medical
25assistance program, enrolled providers shall accept the medical
26assistance reimbursement rate for any covered goods or services
27provided to recipients of medical assistance who are children
28under the custody of a psychiatric medical institution for
29children.
30j. For the fiscal year beginning July 1, 2021, unless
31otherwise specified in this Act, all noninstitutional medical
32assistance provider reimbursement rates shall remain at the
33rates in effect on June 30, 2021, except for area education
34agencies, local education agencies, infant and toddler
35services providers, home and community-based services providers
-57-1including consumer-directed attendant care providers under a
2section 1915(c) or 1915(i) waiver, targeted case management
3providers, and those providers whose rates are required to be
4determined pursuant to section 249A.20, or to meet federal
5mental health parity requirements.
6k. Notwithstanding any provision to the contrary, for the
7fiscal year beginning July 1, 2021, the reimbursement rate for
8anesthesiologists shall remain at the rates in effect on June
930, 2021, and updated on January 1, 2022, to align with the
10most current Iowa Medicare anesthesia rate.
11l. Notwithstanding section 249A.20, for the fiscal year
12beginning July 1, 2021, the average reimbursement rate for
13health care providers eligible for use of the federal Medicare
14resource-based relative value scale reimbursement methodology
15under section 249A.20 shall remain at the rate in effect on
16June 30, 2021; however, this rate shall not exceed the maximum
17level authorized by the federal government.
18m. For the fiscal year beginning July 1, 2021, the
19reimbursement rate for residential care facilities shall not
20be less than the minimum payment level as established by the
21federal government to meet the federally mandated maintenance
22of effort requirement. The flat reimbursement rate for
23facilities electing not to file annual cost reports shall not
24be less than the minimum payment level as established by the
25federal government to meet the federally mandated maintenance
26of effort requirement.
27n. For the fiscal year beginning July 1, 2021, the
28reimbursement rates for inpatient mental health services
29provided at hospitals shall be rebased effective October 1,
302021, subject to Medicaid program upper payment limit rules
31and adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for
33the fiscal year; and psychiatrists shall be reimbursed at the
34medical assistance program fee-for-service rate in effect on
35June 30, 2021.
-58- 1o. For the fiscal year beginning July 1, 2021, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2021.
9p. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2021.
13q. (1) For the fiscal year beginning July 1, 2021,
14reimbursement rates for providers of home and community-based
15services waiver and habilitation services shall be increased
16to the extent possible within the $11,002,240 appropriated for
17this purpose.
18(2) For the fiscal year beginning July 1, 2021,
19reimbursement rates for providers of state plan home and
20community-based services home-based habilitation services
21shall be increased with the $7,134,214 appropriated for this
22purpose. The reimbursement rates for home-based habilitation
23services shall be based on a fee schedule that incorporates the
24acuity-based tiers.
25r. For the fiscal year beginning July 1, 2021, the
26reimbursement rates for emergency medical service providers
27shall remain at the rates in effect on June 30, 2021, or as
28approved by the centers for Medicare and Medicaid services of
29the United States department of health and human services.
30s. For the fiscal year beginning July 1, 2021, reimbursement
31rates for substance-related disorder treatment programs
32licensed under section 125.13 shall remain at the rates in
33effect on June 30, 2021.
34t. For the fiscal year beginning July 1, 2021, assertive
35community treatment per diem rates shall remain at the rates in
-59-1effect on June 30, 2021.
2u. For the fiscal year beginning July 1, 2021, the
3reimbursement rate for family-centered services providers shall
4be established by contract.
5v. For the fiscal year beginning July 1, 2021, the
6reimbursement rate for air ambulance services shall be
7increased to the extent possible within the additional $100,000
8appropriated for this purpose.
92. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers reimbursed under the
11in-home-related care program shall not be less than the minimum
12payment level as established by the federal government to meet
13the federally mandated maintenance of effort requirement.
143. Unless otherwise directed in this section, when the
15department’s reimbursement methodology for any provider
16reimbursed in accordance with this section includes an
17inflation factor, this factor shall not exceed the amount
18by which the consumer price index for all urban consumers
19increased during the calendar year ending December 31, 2002.
204. Notwithstanding section 234.38, for the fiscal
21year beginning July 1, 2021, the foster family basic daily
22maintenance rate and the maximum adoption subsidy rate for
23children ages 0 through 5 years shall be $16.78, the rate for
24children ages 6 through 11 years shall be $17.45, the rate for
25children ages 12 through 15 years shall be $19.10, and the
26rate for children and young adults ages 16 and older shall
27be $19.35. For youth ages 18 to 23 who have exited foster
28care, the preparation for adult living program maintenance
29rate shall be up to $602.70 per month as calculated based on
30the age of the participant. The maximum payment for adoption
31subsidy nonrecurring expenses shall be limited to $500 and the
32disallowance of additional amounts for court costs and other
33related legal expenses implemented pursuant to 2010 Iowa Acts,
34chapter 1031, section 408, shall be continued.
355. For the fiscal year beginning July 1, 2021, the maximum
-60-1reimbursement rates for social services providers under
2contract shall remain at the rates in effect on June 30, 2021,
3or the provider’s actual and allowable cost plus inflation for
4each service, whichever is less. However, if a new service
5or service provider is added after June 30, 2021, the initial
6reimbursement rate for the service or provider shall be based
7upon a weighted average of provider rates for similar services.
86. a. For the fiscal year beginning July 1, 2021, the
9reimbursement rates for resource family recruitment and
10retention contractors shall be established by contract.
11b. For the fiscal year beginning July 1, 2021, the
12reimbursement rates for supervised apartment living foster care
13providers shall be established by contract.
147. For the fiscal year beginning July 1, 2021, the
15reimbursement rate for group foster care providers shall be the
16combined service and maintenance reimbursement rate established
17by contract.
188. The group foster care reimbursement rates paid for
19placement of children out of state shall be calculated
20according to the same rate-setting principles as those used for
21in-state providers, unless the director of human services or
22the director’s designee determines that appropriate care cannot
23be provided within the state. The payment of the daily rate
24shall be based on the number of days in the calendar month in
25which service is provided.
269. a. For the fiscal year beginning July 1, 2021, the
27reimbursement rate paid for shelter care and the child welfare
28emergency services implemented to provide or prevent the need
29for shelter care shall be established by contract.
30b. For the fiscal year beginning July 1, 2021, the combined
31service and maintenance components of the reimbursement rate
32paid for shelter care services shall be based on the financial
33and statistical report submitted to the department. The
34maximum reimbursement rate shall be $101.83 per day. The
35department shall reimburse a shelter care provider at the
-61-1provider’s actual and allowable unit cost, plus inflation, not
2to exceed the maximum reimbursement rate.
3c. Notwithstanding section 232.141, subsection 8, for the
4fiscal year beginning July 1, 2021, the amount of the statewide
5average of the actual and allowable rates for reimbursement of
6juvenile shelter care homes that is utilized for the limitation
7on recovery of unpaid costs shall remain at the amount in
8effect for this purpose in the fiscal year beginning July 1,
92020.
1010. For the fiscal year beginning July 1, 2021, the
11department shall calculate reimbursement rates for intermediate
12care facilities for persons with an intellectual disability
13at the 80th percentile. Beginning July 1, 2021, the rate
14calculation methodology shall utilize the consumer price index
15inflation factor applicable to the fiscal year beginning July
161, 2021.
1711. Effective July 1, 2021, the department of human services
18shall set the reimbursement rate of child care providers whose
19reimbursement rates are below the fiftieth percentile of the
20most recent market rate survey at the fiftieth percentile of
21the most recent market rate survey. Reimbursement rates of
22child care providers whose reimbursement rates are at or above
23the fiftieth percentile of the most recent market rate survey
24shall remain at the rates in effect on June 30, 2021. The
25department shall also adjust quality rating system bonuses to
26reflect increased child care provider reimbursement rates as
27appropriate. The department shall set rates in a manner so as
28to provide incentives for a nonregistered provider to become
29registered by applying any increase only to registered and
30licensed providers.
3112. The department may adopt emergency rules to implement
32this section.
33 Sec. 32. EMERGENCY RULES.
341. If necessary to comply with federal requirements
35including time frames, or if specifically authorized by a
-62-1provision of this division of this Act, the department of
2human services or the mental health and disability services
3commission may adopt administrative rules under section 17A.4,
4subsection 3, and section 17A.5, subsection 2, paragraph “b”,
5to implement the provisions of this division of this Act and
6the rules shall become effective immediately upon filing or
7on a later effective date specified in the rules, unless the
8effective date of the rules is delayed or the applicability
9of the rules is suspended by the administrative rules review
10committee. Any rules adopted in accordance with this section
11shall not take effect before the rules are reviewed by the
12administrative rules review committee. The delay authority
13provided to the administrative rules review committee under
14section 17A.4, subsection 7, and section 17A.8, subsections
159 and 10, shall be applicable to a delay imposed under this
16section, notwithstanding a provision in those subsections
17making them inapplicable to section 17A.5, subsection 2,
18paragraph “b”. Any rules adopted in accordance with the
19provisions of this section shall also be published as a notice
20of intended action as provided in section 17A.4.
212. If during a fiscal year, the department of human
22services is adopting rules in accordance with this section
23or as otherwise directed or authorized by state law, and
24the rules will result in an expenditure increase beyond the
25amount anticipated in the budget process or if the expenditure
26was not addressed in the budget process for the fiscal
27year, the department shall notify the general assembly and
28the department of management concerning the rules and the
29expenditure increase. The notification shall be provided at
30least 30 calendar days prior to the date notice of the rules
31is submitted to the administrative rules coordinator and the
32administrative code editor.
33 Sec. 33. REPORTS. Unless otherwise provided, any reports or
34other information required to be compiled and submitted under
35this Act during the fiscal year beginning July 1, 2021, shall
-63-1be submitted on or before the dates specified for submission
2of the reports or information.
3 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
4of this division of this Act, being deemed of immediate
5importance, takes effect upon enactment:
61. The provision relating to section 232.141 and directing
7the state court administrator and the division administrator of
8the department of human services division of child and family
9services to make the determination, by June 15, 2021, of the
10distribution of funds allocated for the payment of the expenses
11of court-ordered services provided to juveniles which are a
12charge upon the state.
13DIVISION VI
14HEALTH CARE ACCOUNTS AND FUNDS — FY 2021-2022
15 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
16appropriated from the pharmaceutical settlement account created
17in section 249A.33 to the department of human services for the
18fiscal year beginning July 1, 2021, and ending June 30, 2022,
19the following amount, or so much thereof as is necessary, to be
20used for the purpose designated:
21Notwithstanding any provision of law to the contrary, to
22supplement the appropriations made in this Act for health
23program operations under the medical assistance program for the
24fiscal year beginning July 1, 2021, and ending June 30, 2022:
.................................................. $25234,193
26 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
27SERVICES. Notwithstanding any provision to the contrary and
28subject to the availability of funds, there is appropriated
29from the quality assurance trust fund created in section
30249L.4 to the department of human services for the fiscal year
31beginning July 1, 2021, and ending June 30, 2022, the following
32amounts, or so much thereof as is necessary, for the purposes
33designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of human services
-64-1for medical assistance for the same fiscal year:
.................................................. $256,305,139
3 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
4DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
5the contrary and subject to the availability of funds, there is
6appropriated from the hospital health care access trust fund
7created in section 249M.4 to the department of human services
8for the fiscal year beginning July 1, 2021, and ending June
930, 2022, the following amounts, or so much thereof as is
10necessary, for the purposes designated:
11To supplement the appropriation made in this Act from the
12general fund of the state to the department of human services
13for medical assistance for the same fiscal year:
.................................................. $1433,920,554
15 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
16FOR FY 2021-2022. Notwithstanding section 8.33, if moneys
17appropriated for purposes of the medical assistance program for
18the fiscal year beginning July 1, 2021, and ending June 30,
192022, from the general fund of the state, the quality assurance
20trust fund, and the hospital health care access trust fund, are
21in excess of actual expenditures for the medical assistance
22program and remain unencumbered or unobligated at the close
23of the fiscal year, the excess moneys shall not revert but
24shall remain available for expenditure for the purposes of the
25medical assistance program until the close of the succeeding
26fiscal year.
27DIVISION VII
28NURSING FACILITY REIMBURSEMENT METHODOLOGY — FISCAL PERIOD
29JULY 1, 2023, THROUGH JUNE 30, 2025
30 Sec. 39. NURSING FACILITY REIMBURSEMENT METHODOLOGY —
31FISCAL PERIOD JULY 1, 2023, THROUGH JUNE 30, 2025.
32Notwithstanding any provision of law to the contrary, for the
33fiscal period beginning July 1, 2023, and ending June 30, 2025,
34the department of human services shall rebase case-mix nursing
35facility rates beginning July 1, 2023, using the Medicaid cost
-65-1reports on file for the period ending December 31, 2022, and
2applying a minimum occupancy factor of 70 percent.
3DIVISION VIII
4NURSING FACILITY REIMBURSEMENT STUDY
5 Sec. 40. NURSING FACILITY CASE-MIX REIMBURSEMENT — STUDY
6AND RECOMMENDATIONS. The department of human services shall
7convene a workgroup including representatives of nursing
8facilities, managed care organizations, and other appropriate
9stakeholders to review the case-mix reimbursement methodology
10and process for nursing facilities, including but not limited
11to rebasing, the use of cost reports, and the application
12of quarterly case-mix index adjustments, and shall submit
13recommendations to the governor and the general assembly by
14December 1, 2021, for improvements including those related to
15the methodology, the process, the use of prospective payments,
16and the applicable time frames to increase efficiencies
17and accuracy in the determination of reimbursements, reduce
18duplication of effort, more adequately reflect the actual costs
19of care, address changes in patient acuity levels without
20reliance on retroactive rate adjustments, and incentivize
21quality outcomes.
22DIVISION IX
23MEDICAID-ELIGIBLE CHILDREN — PEDIATRIC HEALTH CARE SERVICES
24 Sec. 41. MEDICAID-ELIGIBLE CHILDREN — PROVISION OF
25PEDIATRIC HEALTH CARE SERVICES — REVIEW AND REPORT. The
26department of human services shall review federal Medicare
27and state law and administrative rule restrictions related
28to the provision of physical therapy, occupational therapy,
29speech-language pathology, applied behavior analysis, and other
30pediatric health care services to Medicaid-eligible children
31to determine necessary changes in law and policy to ensure
32that these services are provided consistent with the early and
33periodic screening, diagnostic, and treatment program. The
34department shall submit a report including the findings of the
35review and recommendations to the governor and the general
-66-1assembly by October 1, 2021.
2DIVISION X
3DECATEGORIZATION CARRYOVER FUNDING
4 Sec. 42. DECATEGORIZATION CARRYOVER FUNDING FY 2019 —
5TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
6subsection 5, paragraph “b”, any state-appropriated moneys in
7the funding pool that remained unencumbered or unobligated
8at the close of the fiscal year beginning July 1, 2018, and
9were deemed carryover funding to remain available for the two
10succeeding fiscal years that still remain unencumbered or
11unobligated at the close of the fiscal year beginning July 1,
122020, shall not revert but shall be transferred to the medical
13assistance program for the fiscal year beginning July 1, 2021.
14 Sec. 43. EFFECTIVE DATE. This division of this Act, being
15deemed of immediate importance, takes effect upon enactment.
16 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
17Act applies retroactively to July 1, 2020.
18DIVISION XI
19PRIOR APPROPRIATIONS AND OTHER PROVISIONS
20COURT-ORDERED SERVICES REIMBURSEMENT BY MANAGED CARE
21ORGANIZATIONS
22 Sec. 45. 2018 Iowa Acts, chapter 1165, section 128,
23subsection 2, paragraph a, is amended to read as follows:
24a. If a Medicaid member is receiving court-ordered services
25or treatment for a substance-related disorder pursuant to
26chapter 125 or for a mental illness pursuant to chapter 229,
27such services or treatment shall be provided and reimbursed
28for an initial period of three days before a managed care
29organization may apply medical necessity criteria to determine
30the most appropriate services, treatment, or placement for the
31Medicaid member.
32FAMILY INVESTMENT PROGRAM ACCOUNT
33 Sec. 46. 2019 Iowa Acts, chapter 85, section 9, as amended
34by 2020 Iowa Acts, chapter 1121, section 20, is amended by
35adding the following new subsection:
-67-1 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
2appropriated in this section that remain unencumbered or
3unobligated at the close of the fiscal year shall not revert
4but shall remain available for expenditure for the purposes
5designated, and may be transferred to other appropriations made
6in this division of this Act as necessary to carry out the
7initiatives included in the report submitted on nonreversion
8of funds required pursuant to 2020 Iowa Acts, chapter 1121,
9section 43, until the close of the succeeding fiscal year.
10Child and family services
11 Sec. 47. 2019 Iowa Acts, chapter 85, section 19, as amended
12by 2020 Iowa Acts, chapter 1121, section 23, is amended by
13adding the following new subsection:
14 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
15appropriated in this section that remain unencumbered or
16unobligated at the close of the fiscal year shall not revert
17but shall remain available for expenditure for the purpose of
18the redesign of the child welfare system, until the close of
19the succeeding fiscal year.
20FIELD OPERATIONS
21 Sec. 48. 2019 Iowa Acts, chapter 85, section 27, as amended
22by 2020 Iowa Acts, chapter 1121, section 25, is amended by
23adding the following new subsection:
24 NEW SUBSECTION. 5. Notwithstanding section 8.33, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for expenditure for the purposes
28designated until the close of the succeeding fiscal year.
29GENERAL ADMINISTRATION
30 Sec. 49. 2019 Iowa Acts, chapter 85, section 28, as amended
31by 2020 Iowa Acts, chapter 1121, section 26, is amended by
32adding the following new subsection:
33 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-68-1but shall remain available for expenditure for the purposes
2designated until the close of the succeeding fiscal year.
3 Sec. 50. EFFECTIVE DATE. This division of this Act, being
4deemed of immediate importance, takes effect upon enactment.
5DIVISION XII
6EXTENSION OF FUTURE REPEAL — HOSPITAL HEALTH CARE ACCESS
7ASSESSMENT PROGRAM
8 Sec. 51. Section 249M.5, Code 2021, is amended to read as
9follows:
10249M.5 Future repeal.
11This chapter is repealed July 1, 2021 2023.
12 Sec. 52. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION XIII
15PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
16 Sec. 53. COVID-19 FEDERAL REGULATIONS. For the time
17period beginning on the effective date of this division of
18this Act, and ending June 30, 2022, notwithstanding state
19administrative rules to the contrary, to the extent federal
20regulations relating to the COVID-19 pandemic differ from state
21administrative rules, including applicable federal waivers,
22the federal regulations are controlling during the pendency of
23the federally declared state of emergency and for such period
24of time following the end of the federally declared state of
25emergency applicable to the respective federal regulations.
26DIVISION XIV
27FOSTER HOME INSURANCE FUND
28 Sec. 54. Section 237.13, subsection 2, Code 2021, is amended
29to read as follows:
302. The foster home insurance fund shall be administered by
31the department of human services. The fund shall consist of
32all moneys appropriated by the general assembly for deposit
33in the fund. The department shall use moneys in the fund to
34provide home and property coverage for foster parents to cover
35damages to property resulting from the actions of a foster
-69-1child residing in a foster home or to reimburse foster parents
2for the cost of purchasing foster care liability insurance and
3to perform the administrative functions necessary to carry out
4this section. The department may establish limitations of
5liability for individual claims as deemed reasonable by the
6department.
7DIVISION XV
8MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER OF FUNDS
9 Sec. 55. MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER
10OF FUNDS. Notwithstanding section 331.432, a county with a
11population of over 300,000 based on the 2010 federal decennial
12census may transfer funds from any other fund of the county to
13the mental health and disability regional services fund for the
14purposes of providing mental health and disability services for
15the fiscal year beginning July 1, 2021, and ending June 30,
162022. The county shall submit a report to the governor and the
17general assembly by September 1, 2022, including the source of
18any funds transferred, the amount of the funds transferred, and
19the mental health and disability services provided with the
20transferred funds. The county shall work with the department
21to maximize the use of the medical assistance program and other
22third-party payment sources, including but not limited to
23identifying individuals enrolled with or eligible for Medicaid
24whose Medicaid-covered services are being paid by the county or
25could be converted to Medicaid-covered services.
26DIVISION XVI
27IN-PERSON SUPERVISION REQUIREMENTS FOR LICENSURE — CERTAIN
28PROFESSIONALS
29 Sec. 56. Section 154C.3, subsection 1, paragraph c,
30subparagraph (5), subparagraph division (a), Code 2021, is
31amended by adding the following new subparagraph subdivision:
32 NEW SUBPARAGRAPH SUBDIVISION. (0ii) By a person licensed
33under section 154D.2 to practice marital and family therapy
34without supervision or mental health counseling without
35supervision.
-70-1 Sec. 57. Section 154C.3, Code 2021, is amended by adding the
2following new subsection:
3 NEW SUBSECTION. 4. Supervision. The board shall not, by
4rule or other means, require that supervision be completed in
5person as a condition for an applicant to receive a license, a
6reciprocal license, or a renewed license under this chapter.
7 Sec. 58. Section 154D.2, Code 2021, is amended to read as
8follows:
9154D.2 Licensure — marital and family therapy — mental
10health counseling.
111. An applicant for a license to practice marital and family
12therapy or mental health counseling shall be granted a license
13by the board when the applicant satisfies all of the following
14requirements:
151. a. Possesses a master’s degree in marital and family
16therapy or mental health counseling, as applicable, consisting
17of at least sixty semester hours, or its equivalent, from a
18nationally accredited institution or from a program approved
19by the board.
202. b. Has at least two years of supervised clinical
21experience or its equivalent as approved by the board.
22Standards for supervision, including the required
23qualifications for supervisors, shall be determined in
24accordance with subsection 2 and by the board by rule, provided
25that a supervisor may be a person licensed under this section
26to practice marital and family therapy or mental health
27counseling without supervision or a licensed independent social
28worker licensed under chapter 154C.
293. c. Passes an examination approved by the board.
302. The board shall not, by rule or other means, require any
31in-person supervised clinical experience.
32 Sec. 59. Section 154D.4, subsection 2, paragraph b, Code
332021, is amended to read as follows:
34b. A person who practices marital and family therapy or
35mental health counseling under the supervision of a person
-71-1licensed under this chapter as part of a clinical experience as
2described in section 154D.2, subsection 2 1, paragraph “b”.
3 Sec. 60. BOARD OF SOCIAL WORK AND BOARD OF BEHAVIORAL
4SCIENCE — RULES. The board of social work and the board
5of behavioral science shall amend their administrative
6rules pursuant to chapter 17A to remove any requirement for
7supervised clinical experience and supervised professional
8practice to be completed in person as a condition for the
9licensure of marital and family therapists, mental health
10counselors, and social workers pursuant to chapters 154C and
11154D. The board of social work and the board of behavioral
12science shall replace all licensing requirements for in-person
13supervision with the ability to have supervision requirements
14completed electronically.
15 Sec. 61. EMERGENCY RULES.
161. The board of social work and the board of behavioral
17science shall adopt emergency rules under section 17A.4,
18subsection 3, and section 17A.5, subsection 2, to implement
19the sections of this division of this Act amending section
20154C.3 and section 154D.2, and the rules shall be effective
21immediately upon filing unless a later date is specified in the
22rules. Any emergency rules adopted in accordance with this
23section shall also be published as a notice of intended action
24as provided in section 17A.4, subsection 1.
252. The board of social work and the board of behavioral
26science shall jointly develop rules adopted pursuant to this
27subsection through a collaborative process. The respective
28boards may establish subcommittees or designate other personnel
29to facilitate such a process. Such rules shall consist of
30substantively identical standards applicable to the professions
31regulated by the respective boards and shall, to the greatest
32extent possible, consist of substantially similar language
33in a substantially similar format. Prior to a vote to adopt
34such rules by either board, each board shall, by a separate
35vote, approve the language to be adopted by the other board.
-72-1Neither board shall vote to adopt such rules until the rules
2to be adopted by both boards have been so approved. Such rules
3shall have the same effective date and shall be submitted to
4the administrative rules coordinator and the administrative
5code editor for publication in the same issue of the Iowa
6administrative bulletin pursuant to sections 17A.4 and 17A.5.
7 Sec. 62. EFFECTIVE DATE. This division of this Act, being
8deemed of immediate importance, takes effect upon enactment.
9DIVISION XVII
10MEDICAL RESIDENCY LIABILITY COSTS
11 Sec. 63. Section 135.176, subsection 1, Code 2021, is
12amended by adding the following new paragraph:
13 NEW PARAGRAPH. d. For the period beginning July 1, 2021,
14and ending June 30, 2026, the payment by the sponsor of medical
15residency program liability costs subject to provision by the
16sponsor of dollar-for-dollar matching funds used for payment
17of such costs. This paragraph shall not apply to medical
18residency programs to which chapter 669 applies.
19 Sec. 64. Section 135.176, subsection 2, paragraphs e and f,
20Code 2021, are amended to read as follows:
21e. The maximum award of grant funds to a particular
22individual sponsor per year. An individual sponsor that
23establishes a new or alternative campus accredited medical
24residency training program as defined in subsection 1,
25paragraph “a”, shall not receive more than fifty percent
26of the state matching funds available each year to support
27the program. An individual sponsor proposing the provision
28of a new residency position within an existing accredited
29medical residency or fellowship training program as specified
30in subsection 1, paragraph “b”, or the funding of residency
31positions which are in excess of the federal residency cap as
32defined in subsection 1, paragraph “c”, or the funding of the
33payment by the sponsor of medical residency program liability
34costs subject to provision by the sponsor of dollar-for-dollar
35matching funds used for payment of such costs as specified
-73-1in subsection 1, paragraph “d”, shall not receive more than
2twenty-five percent of the state matching funds available each
3year to support the program.
4f. Use of the funds awarded. Funds may be used to pay the
5costs of establishing, expanding, or supporting an accredited
6graduate medical education program as specified in this
7section, including but not limited to the costs associated
8with residency stipends and physician faculty stipends. For
9the period beginning July 1, 2021, and ending June 30, 2026,
10use of the funds awarded may include payment by the sponsor of
11medical residency program liability costs in accordance with
12subsection 1, paragraph “d”, and subject to provision by the
13sponsor of dollar-for-dollar matching funds used for payment
14of such costs.
15DIVISION XVIII
16REPORT ON NONREVERSION OF FUNDS
17 Sec. 65. REPORT ON NONREVERSION OF FUNDS. The department
18of human services shall report the expenditure of any moneys
19for which nonreversion authorization was provided for the
20fiscal year beginning July 1, 2020, and ending June 30, 2021,
21for field operations or general administration to the general
22assembly on a quarterly basis beginning October 1, 2021.
23DIVISION XIX
24PHYSICIAN ORDERS FOR SCOPE OF TREATMENT
25 Sec. 66. Section 144D.2, subsection 1, paragraph e,
26subparagraph (4), Code 2021, is amended by striking the
27subparagraph.
pf/rn/md
2services and veterans and including other related provisions
3and appropriations, providing penalties, and including
4effective date and retroactive and other applicability date
5provisions.
6BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1DIVISION I
2DEPARTMENT ON AGING — FY 2021-2022
3 Section 1. DEPARTMENT ON AGING. There is appropriated from
4the general fund of the state to the department on aging for
5the fiscal year beginning July 1, 2021, and ending June 30,
62022, the following amount, or so much thereof as is necessary,
7to be used for the purposes designated:
8For aging programs for the department on aging and area
9agencies on aging to provide citizens of Iowa who are 60
10years of age and older with case management, Iowa’s aging and
11disabilities resource center, and other services which may
12include but are not limited to adult day, respite care, chore,
13information and assistance, and material aid, for information
14and options counseling for persons with disabilities who
15are 18 years of age or older, and for salaries, support,
16administration, maintenance, and miscellaneous purposes, and
17for not more than the following full-time equivalent positions:
.................................................. $1811,304,082
............................................... FTEs1927.00
201. Funds appropriated in this section may be used to
21supplement federal funds under federal regulations. To
22receive funds appropriated in this section, a local area
23agency on aging shall match the funds with moneys from other
24sources according to rules adopted by the department. Funds
25appropriated in this section may be used for elderly services
26not specifically enumerated in this section only if approved
27by an area agency on aging for provision of the service within
28the area.
292. Of the funds appropriated in this section, $418,700 is
30transferred to the economic development authority for the Iowa
31commission on volunteer services to be used for the retired and
32senior volunteer program.
333. a. The department on aging shall establish and enforce
34procedures relating to expenditure of state and federal funds
35by area agencies on aging that require compliance with both
-1-1state and federal laws, rules, and regulations, including but
2not limited to all of the following:
3(1) Requiring that expenditures are incurred only for goods
4or services received or performed prior to the end of the
5fiscal period designated for use of the funds.
6(2) Prohibiting prepayment for goods or services not
7received or performed prior to the end of the fiscal period
8designated for use of the funds.
9(3) Prohibiting prepayment for goods or services not
10defined specifically by good or service, time period, or
11recipient.
12(4) Prohibiting the establishment of accounts from which
13future goods or services which are not defined specifically by
14good or service, time period, or recipient, may be purchased.
15b. The procedures shall provide that if any funds are
16expended in a manner that is not in compliance with the
17procedures and applicable federal and state laws, rules, and
18regulations, and are subsequently subject to repayment, the
19area agency on aging expending such funds in contravention of
20such procedures, laws, rules and regulations, not the state,
21shall be liable for such repayment.
224. Of the funds appropriated in this section, at least
23$600,000 shall be used to fund home and community-based
24services through the area agencies on aging that enable older
25individuals to avoid more costly utilization of residential or
26institutional services and remain in their own homes.
275. Of the funds appropriated in this section, $812,000 shall
28be used for the purposes of chapter 231E and to administer
29the prevention of elder abuse, neglect, and exploitation
30program pursuant to section 231.56A, in accordance with the
31requirements of the federal Older Americans Act of 1965, 42
32U.S.C.§3001 et seq., as amended.
336. Of the funds appropriated in this section, $1,000,000
34shall be used to fund continuation of the aging and disability
35resource center lifelong links to provide individuals and
-2-1caregivers with information and services to plan for and
2maintain independence.
37. Of the funds appropriated in this section, $250,000
4shall be used by the department on aging, in collaboration with
5the department of human services and affected stakeholders,
6to continue to expand the pilot initiative to provide
7long-term care options counseling utilizing support planning
8protocols, to assist non-Medicaid eligible consumers who
9indicate a preference to return to the community and are
10deemed appropriate for discharge, to return to their community
11following a nursing facility stay. The department on aging
12shall submit a report regarding the outcomes of the pilot
13initiative to the governor and the general assembly by December
1415, 2021.
15DIVISION II
16OFFICE OF LONG-TERM CARE oMBUDSMAN — FY 2021-2022
17 Sec. 2. OFFICE OF LONG-TERM CARE OMBUDSMAN. There is
18appropriated from the general fund of the state to the office
19of long-term care ombudsman for the fiscal year beginning July
201, 2021, and ending June 30, 2022, the following amount, or
21so much thereof as is necessary, to be used for the purposes
22designated:
23For salaries, support, administration, maintenance, and
24miscellaneous purposes, and for not more than the following
25full-time equivalent positions:
.................................................. $261,149,821
............................................... FTEs2716.00
28DIVISION III
29DEPARTMENT OF PUBLIC HEALTH — FY 2021-2022
30 Sec. 3. DEPARTMENT OF PUBLIC HEALTH. There is appropriated
31from the general fund of the state to the department of public
32health for the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the following amounts, or so much thereof as is
34necessary, to be used for the purposes designated:
351. ADDICTIVE DISORDERS
-3- 1For reducing the prevalence of the use of tobacco, alcohol,
2and other drugs, and treating individuals affected by addictive
3behaviors, including gambling, and for not more than the
4following full-time equivalent positions:
.................................................. $523,659,379
............................................... FTEs612.00
7a. (1) Of the funds appropriated in this subsection,
8$4,020,894 shall be used for the tobacco use prevention
9and control initiative, including efforts at the state and
10local levels, as provided in chapter 142A. The commission
11on tobacco use prevention and control established pursuant
12to section 142A.3 shall advise the director of public health
13in prioritizing funding needs and the allocation of moneys
14appropriated for the programs and initiatives. Activities
15of the programs and initiatives shall be in alignment with
16the United States centers for disease control and prevention
17best practices for comprehensive tobacco control programs
18that include the goals of preventing youth initiation of
19tobacco usage, reducing exposure to secondhand smoke, and
20promotion of tobacco cessation. To maximize resources,
21the department shall determine if third-party sources are
22available to instead provide nicotine replacement products
23to an applicant prior to provision of such products to an
24applicant under the initiative. The department shall track and
25report to the governor and the general assembly any reduction
26in the provision of nicotine replacement products realized
27by the initiative through implementation of the prerequisite
28screening.
29(2) (a) The department shall collaborate with the
30alcoholic beverages division of the department of commerce for
31enforcement of tobacco laws, regulations, and ordinances and to
32engage in tobacco control activities approved by the division
33of tobacco use prevention and control of the department of
34public health as specified in the memorandum of understanding
35entered into between the divisions.
-4- 1(b) For the fiscal year beginning July 1, 2021, and ending
2June 30, 2022, the terms of the memorandum of understanding,
3entered into between the division of tobacco use prevention
4and control of the department of public health and the
5alcoholic beverages division of the department of commerce,
6governing compliance checks conducted to ensure licensed retail
7tobacco outlet conformity with tobacco laws, regulations, and
8ordinances relating to persons under 21 years of age, shall
9continue to restrict the number of such checks to one check per
10retail outlet, and one additional check for any retail outlet
11found to be in violation during the first check.
12b. (1) Of the funds appropriated in this subsection,
13$19,638,485 shall be used for problem gambling and
14substance-related disorder prevention, treatment, and recovery
15services, including a 24-hour helpline, public information
16resources, professional training, youth prevention, and program
17evaluation.
18(2) Of the amount allocated under this paragraph, $306,000
19shall be utilized by the department of public health, in
20collaboration with the department of human services, to
21maintain a single statewide 24-hour crisis hotline for the Iowa
22children’s behavioral health system that incorporates warmline
23services which may be provided through expansion of existing
24capabilities maintained by the department of public health as
25required pursuant to 2018 Iowa Acts, chapter 1056, section 16.
26c. The requirement of section 123.17, subsection 5, is met
27by the appropriations and allocations made in this division of
28this Act for purposes of substance-related disorder treatment
29and addictive disorders for the fiscal year beginning July 1,
302021.
312. HEALTHY CHILDREN AND FAMILIES
32For promoting the optimum health status for children and
33adolescents from birth through 21 years of age, and families,
34and for not more than the following full-time equivalent
35positions:
-5-.................................................. $15,816,681
............................................... FTEs214.00
3a. Of the funds appropriated in this subsection, not more
4than $734,000 shall be used for the healthy opportunities for
5parents to experience success (HOPES)-healthy families Iowa
6(HFI) program established pursuant to section 135.106.
7b. In order to implement the legislative intent stated
8in sections 135.106 and 256I.9, priority for home visitation
9program funding shall be given to programs using evidence-based
10or promising models for home visitation.
11c. Of the funds appropriated in this subsection, $3,075,000
12shall be used for continuation of the department’s initiative
13to provide for adequate developmental surveillance and
14screening during a child’s first five years. The funds shall
15be used first to fully fund the current sites to ensure that
16the sites are fully operational, with the remaining funds
17to be used for expansion to additional sites. The full
18implementation and expansion shall include enhancing the scope
19of the initiative through collaboration with the child health
20specialty clinics to promote healthy child development through
21early identification and response to both biomedical and social
22determinants of healthy development; by monitoring child
23health metrics to inform practice, document long-term health
24impacts and savings, and provide for continuous improvement
25through training, education, and evaluation; and by providing
26for practitioner consultation particularly for children with
27behavioral conditions and needs. The department of public
28health shall also collaborate with the Iowa Medicaid enterprise
29and the child health specialty clinics to integrate the
30activities of the first five initiative into the establishment
31of patient-centered medical homes, community utilities,
32accountable care organizations, and other integrated care
33models developed to improve health quality and population
34health while reducing health care costs. To the maximum extent
35possible, funding allocated in this paragraph shall be utilized
-6-1as matching funds for medical assistance program reimbursement.
2d. Of the funds appropriated in this subsection, $64,000
3shall be distributed to a statewide dental carrier to provide
4funds to continue the donated dental services program patterned
5after the projects developed by the dental lifeline network to
6provide dental services to indigent individuals who are elderly
7or with disabilities.
8e. Of the funds appropriated in this subsection, $156,000
9shall be used to provide audiological services and hearing aids
10for children.
11f. Of the funds appropriated in this subsection, $23,000 is
12transferred to the university of Iowa college of dentistry for
13provision of primary dental services to children. State funds
14shall be matched on a dollar-for-dollar basis. The university
15of Iowa college of dentistry shall coordinate efforts with the
16department of public health, oral and health delivery system
17bureau, to provide dental care to underserved populations
18throughout the state.
19g. Of the funds appropriated in this subsection, $50,000
20shall be used to address youth suicide prevention.
21h. Of the funds appropriated in this subsection, $40,000
22shall be used to support the Iowa effort to address the survey
23of children who experience adverse childhood experiences known
24as ACEs.
25i. Of the funds appropriated in this subsection, up to
26$494,000 shall be used for childhood obesity prevention.
273. CHRONIC CONDITIONS
28For serving individuals identified as having chronic
29conditions or special health care needs, and for not more than
30the following full-time equivalent positions:
.................................................. $314,258,373
............................................... FTEs3210.00
33a. Of the funds appropriated in this subsection, $188,000
34shall be used for grants to individual patients who have an
35inherited metabolic disorder to assist with the costs of
-7-1medically necessary foods and formula.
2b. Of the funds appropriated in this subsection, $1,055,000
3shall be used for the brain injury services program pursuant
4to section 135.22B, including $861,000 for contracting with an
5existing nationally affiliated and statewide organization whose
6purpose is to educate, serve, and support Iowans with brain
7injury and their families, for resource facilitator services
8in accordance with section 135.22B, subsection 9, and for
9contracting to enhance brain injury training and recruitment
10of service providers on a statewide basis. Of the amount
11allocated in this paragraph, $95,000 shall be used to fund
121.00 full-time equivalent position to serve as the state brain
13injury services program manager.
14c. Of the funds appropriated in this subsection, $144,000
15shall be used for the public purpose of continuing to contract
16with an existing nationally affiliated organization to provide
17education, client-centered programs, and client and family
18support for people living with epilepsy and their families.
19The amount allocated in this paragraph in excess of $50,000
20shall be matched dollar-for-dollar by the organization
21specified. Funds allocated under this paragraph shall be
22distributed in their entirety for the purpose specified on July
231, 2021.
24d. Of the funds appropriated in this subsection, $809,000
25shall be used for child health specialty clinics.
26e. Of the funds appropriated in this subsection, $384,000
27shall be used by the regional autism assistance program
28established pursuant to section 256.35, and administered by
29the child health specialty clinic located at the university of
30Iowa hospitals and clinics. The funds shall be used to enhance
31interagency collaboration and coordination of educational,
32medical, and other human services for persons with autism,
33their families, and providers of services, including delivering
34regionalized services of care coordination, family navigation,
35and integration of services through the statewide system of
-8-1regional child health specialty clinics and fulfilling other
2requirements as specified in chapter 225D. The university of
3Iowa shall not receive funds allocated under this paragraph for
4indirect costs associated with the regional autism assistance
5program.
6f. Of the funds appropriated in this subsection, $577,000
7shall be used for the comprehensive cancer control program to
8reduce the burden of cancer in Iowa through prevention, early
9detection, effective treatment, and ensuring quality of life.
10Of the funds allocated in this paragraph “f”, $150,000 shall
11be used to support a melanoma research symposium, a melanoma
12biorepository and registry, basic and translational melanoma
13research, and clinical trials.
14g. Of the funds appropriated in this subsection, $97,000
15shall be used for cervical and colon cancer screening, and
16$177,000 shall be used to enhance the capacity of the cervical
17cancer screening program to include provision of recommended
18prevention and early detection measures to a broader range of
19low-income women.
20h. Of the funds appropriated in this subsection, $506,000
21shall be used for the center for congenital and inherited
22disorders.
234. COMMUNITY CAPACITY
24For strengthening the health care delivery system at the
25local level, and for not more than the following full-time
26equivalent positions:
.................................................. $277,319,306
............................................... FTEs2813.00
29a. Of the funds appropriated in this subsection, $95,000
30is allocated for continuation of the child vision screening
31program implemented through the university of Iowa hospitals
32and clinics in collaboration with early childhood Iowa areas.
33The program shall submit a report to the department regarding
34the use of funds allocated under this paragraph “a”. The
35report shall include the objectives and results for the
-9-1program year including the target population and how the funds
2allocated assisted the program in meeting the objectives; the
3number, age, and location within the state of individuals
4served; the type of services provided to the individuals
5served; the distribution of funds based on service provided;
6and the continuing needs of the program.
7b. Of the funds appropriated in this subsection,
8$48,000 shall be used for a grant to a statewide association
9of psychologists, that is affiliated with the American
10psychological association, to be used for continuation of a
11program to rotate intern psychologists in placements that
12serve urban and rural mental health professional shortage
13areas. Once an intern psychologist begins service, the intern
14psychologist may continue serving in the location of the intern
15psychologist’s placement, notwithstanding any change in the
16mental health professional shortage area designation of such
17location. The intern psychologist may also provide services
18via telehealth, to underserved populations, and to Medicaid
19members. For the purposes of this paragraph “b”, “mental
20health professional shortage area” means a geographic area
21in this state that has been designated by the United States
22department of health and human services, health resources and
23services administration, bureau of health professionals, as
24having a shortage of mental health professionals.
25c. Of the funds appropriated in this subsection, the
26following amounts are allocated to be used as follows
27to support the goals of increased access, health system
28integration, and engagement:
29(1) Not less than $1,600,000 is allocated to the Iowa
30prescription drug corporation for continuation of the
31pharmaceutical infrastructure for safety net providers as
32described in 2007 Iowa Acts, chapter 218, section 108, and for
33the prescription drug donation repository program created in
34chapter 135M. Of the amount allocated in this subparagraph,
35$1,000,000 shall be used as one-time funding to support
-10-1program expansion and to implement an automated multi-dose
2prescription packaging system. Funds allocated under this
3subparagraph shall be distributed in their entirety for the
4purpose specified on July 1, 2021.
5(2) Not less than $334,000 is allocated to free clinics and
6free clinics of Iowa for necessary infrastructure, statewide
7coordination, provider recruitment, service delivery, and
8provision of assistance to patients in securing a medical home
9inclusive of oral health care. Funds allocated under this
10subparagraph shall be distributed in their entirety for the
11purpose specified on July 1, 2021.
12(3) Not less than $25,000 is allocated to the Iowa
13association of rural health clinics for necessary
14infrastructure and service delivery transformation. Funds
15allocated under this subparagraph shall be distributed in their
16entirety for the purpose specified on July 1, 2021.
17(4) Not less than $225,000 is allocated to the Polk county
18medical society for continuation of the safety net provider
19patient access to specialty health care initiative as described
20in 2007 Iowa Acts, chapter 218, section 109. Funds allocated
21under this subparagraph shall be distributed in their entirety
22for the purpose specified on July 1, 2021.
23d. Of the funds appropriated in this subsection, $191,000
24is allocated for the purposes of health care and public health
25workforce initiatives.
26e. Of the funds appropriated in this subsection, $96,000
27shall be used for a matching dental education loan repayment
28program to be allocated to a dental nonprofit health service
29corporation to continue to develop the criteria and implement
30the loan repayment program.
31f. Of the funds appropriated in this subsection, $100,000
32shall be used for the purposes of the Iowa donor registry as
33specified in section 142C.18.
34g. Of the funds appropriated in this subsection, $96,000
35shall be used for continuation of a grant to a nationally
-11-1affiliated volunteer eye organization that has an established
2program for children and adults and that is solely dedicated to
3preserving sight and preventing blindness through education,
4nationally certified vision screening and training, and
5community and patient service programs. The contractor shall
6submit a report to the general assembly regarding the use
7of funds allocated under this paragraph “g”. The report
8shall include the objectives and results for the program year
9including the target population and how the funds allocated
10assisted the program in meeting the objectives; the number,
11age, grade level if appropriate, and location within the state
12of individuals served; the type of services provided to the
13individuals served; the distribution of funds based on services
14provided; and the continuing needs of the program.
15h. Of the funds appropriated in this subsection, $2,100,000
16shall be deposited in the medical residency training account
17created in section 135.175, subsection 5, paragraph “a”, and
18is appropriated from the account to the department of public
19health to be used for the purposes of the medical residency
20training state matching grants program as specified in section
21135.176.
22i. Of the funds appropriated in this subsection, $250,000
23shall be used for the public purpose of providing funding to
24Des Moines university to continue a provider education project
25to provide primary care physicians with the training and skills
26necessary to recognize the signs of mental illness in patients.
27j. Of the funds appropriated in this subsection, $600,000
28shall be used for rural psychiatric residencies to support the
29annual creation and training of four psychiatric residents who
30will provide mental health services in underserved areas of
31the state. Notwithstanding section 8.33, moneys that remain
32unencumbered or unobligated at the close of the fiscal year
33shall not revert but shall remain available for expenditure for
34the purposes designated for subsequent fiscal years.
35k. Of the funds appropriated in this subsection, $150,000
-12-1shall be used for psychiatric training to increase access to
2mental health care services by expanding the mental health
3workforce via training of additional physician assistants and
4nurse practitioners.
51. Of the funds appropriated in this subsection, $425,000
6shall be used for the creation of a center of excellence
7program to encourage innovation and collaboration among
8regional health care providers in a rural area based upon the
9results of a regional community needs assessment to transform
10health care delivery in order to provide quality, sustainable
11care that meets the needs of the local communities. An
12applicant for the funds shall specify how the funds will be
13expended to accomplish the goals of the program and shall
14provide a detailed five-year sustainability plan prior to
15being awarded any funding. Following the receipt of funding,
16a recipient shall submit periodic reports as specified by the
17department to the governor and the general assembly regarding
18the recipient’s expenditure of the funds and progress in
19accomplishing the program goals.
205. ESSENTIAL PUBLIC HEALTH SERVICES
21To provide public health services that reduce risks and
22invest in promoting and protecting good health over the
23course of a lifetime with a priority given to older Iowans and
24vulnerable populations:
.................................................. $257,662,464
266. INFECTIOUS DISEASES
27For reducing the incidence and prevalence of communicable
28diseases, and for not more than the following full-time
29equivalent positions:
.................................................. $301,796,206
............................................... FTEs316.00
327. PUBLIC PROTECTION
33For protecting the health and safety of the public through
34establishing standards and enforcing regulations, and for not
35more than the following full-time equivalent positions:
-13-.................................................. $14,466,601
............................................... FTEs2142.00
3a. Of the funds appropriated in this subsection, not more
4than $304,000 shall be credited to the emergency medical
5services fund created in section 135.25. Moneys in the
6emergency medical services fund are appropriated to the
7department to be used for the purposes of the fund.
8b. Of the funds appropriated in this subsection, up
9to $243,000 shall be used for sexual violence prevention
10programming through a statewide organization representing
11programs serving victims of sexual violence through the
12department’s sexual violence prevention program, and for
13continuation of a training program for sexual assault
14response team (SART) members, including representatives of
15law enforcement, victim advocates, prosecutors, and certified
16medical personnel. The amount allocated in this paragraph “b”
17shall not be used to supplant funding administered for other
18sexual violence prevention or victims assistance programs.
19c. Of the funds appropriated in this subsection, up to
20$500,000 shall be used for the state poison control center.
21Pursuant to the directive under 2014 Iowa Acts, chapter
221140, section 102, the federal matching funds available to
23the state poison control center from the department of human
24services under the federal Children’s Health Insurance Program
25Reauthorization Act allotment shall be subject to the federal
26administrative cap rule of 10 percent applicable to funding
27provided under Tit.XXI of the federal Social Security Act and
28included within the department’s calculations of the cap.
29d. Of the funds appropriated in this subsection, up to
30$504,000 shall be used for childhood lead poisoning provisions.
318. RESOURCE MANAGEMENT
32For establishing and sustaining the overall ability of the
33department to deliver services to the public, and for not more
34than the following full-time equivalent positions:
.................................................. $35933,871
-14-............................................... FTEs14.00
29. MISCELLANEOUS PROVISIONS
3The university of Iowa hospitals and clinics under the
4control of the state board of regents shall not receive
5indirect costs from the funds appropriated in this section.
6The university of Iowa hospitals and clinics billings to the
7department shall be on at least a quarterly basis.
8 Sec. 4. DEPARTMENT OF PUBLIC HEALTH — SPORTS WAGERING
9RECEIPTS FUND. There is appropriated from the sports wagering
10receipts fund created in section 8.57, subsection 6, to the
11department of public health for the fiscal year beginning July
121, 2021, and ending June 30, 2022, the following amount, or
13so much thereof as is necessary, to be used for the purposes
14designated:
15For problem gambling and substance-related disorder
16prevention, treatment, and recovery services, including a
1724-hour helpline, public information resources, professional
18training, youth prevention, and program evaluation:
.................................................. $191,750,000
20DIVISION IV
21DEPARTMENT OF VETERANS AFFAIRS — FY 2021-2022
22 Sec. 5. DEPARTMENT OF VETERANS AFFAIRS. There is
23appropriated from the general fund of the state to the
24department of veterans affairs for the fiscal year beginning
25July 1, 2021, and ending June 30, 2022, the following amounts,
26or so much thereof as is necessary, to be used for the purposes
27designated:
281. DEPARTMENT OF VETERANS AFFAIRS ADMINISTRATION
29For salaries, support, maintenance, and miscellaneous
30purposes, and for not more than the following full-time
31equivalent positions:
.................................................. $321,229,763
............................................... FTEs3315.00
342. IOWA VETERANS HOME
35For salaries, support, maintenance, and miscellaneous
-15-1purposes:
.................................................. $27,131,552
3a. The Iowa veterans home billings involving the department
4of human services shall be submitted to the department on at
5least a monthly basis.
6b. The Iowa veterans home expenditure report shall be
7submitted monthly to the general assembly.
8c. The Iowa veterans home shall continue to include in the
9annual discharge report applicant information to provide for
10the collection of demographic information including but not
11limited to the number of individuals applying for admission and
12admitted or denied admittance and the basis for the admission
13or denial; the age, gender, and race of such individuals;
14and the level of care for which such individuals applied for
15admission including residential or nursing level of care.
163. HOME OWNERSHIP ASSISTANCE PROGRAM
17For transfer to the Iowa finance authority for the
18continuation of the home ownership assistance program for
19persons who are or were eligible members of the armed forces of
20the United States, pursuant to section 16.54:
.................................................. $212,000,000
22 Sec. 6. LIMITATION OF COUNTY COMMISSIONS OF VETERAN AFFAIRS
23FUND STANDING APPROPRIATIONS. Notwithstanding the standing
24appropriation in section 35A.16 for the fiscal year beginning
25July 1, 2021, and ending June 30, 2022, the amount appropriated
26from the general fund of the state pursuant to that section
27for the following designated purposes shall not exceed the
28following amount:
29For the county commissions of veteran affairs fund under
30section 35A.16:
.................................................. $31990,000
32DIVISION V
33DEPARTMENT OF HUMAN SERVICES — FY 2021-2022
34 Sec. 7. TEMPORARY ASSISTANCE FOR NEEDY FAMILIES BLOCK
35GRANT. There is appropriated from the fund created in section
-16-18.41 to the department of human services for the fiscal year
2beginning July 1, 2021, and ending June 30, 2022, from moneys
3received under the federal temporary assistance for needy
4families (TANF) block grant pursuant to the federal Personal
5Responsibility and Work Opportunity Reconciliation Act of 1996,
6Pub.L.No.104-193, and successor legislation, the following
7amounts, or so much thereof as is necessary, to be used for the
8purposes designated:
91. To be credited to the family investment program account
10and used for assistance under the family investment program
11under chapter 239B:
.................................................. $125,002,006
132. To be credited to the family investment program account
14and used for the job opportunities and basic skills (JOBS)
15program and implementing family investment agreements in
16accordance with chapter 239B:
.................................................. $175,412,060
183. To be used for the family development and
19self-sufficiency grant program in accordance with section
20216A.107:
.................................................. $212,888,980
22Notwithstanding section 8.33, moneys appropriated in this
23subsection that remain unencumbered or unobligated at the close
24of the fiscal year shall not revert but shall remain available
25for expenditure for the purposes designated until the close of
26the succeeding fiscal year. However, unless such moneys are
27encumbered or obligated on or before September 30, 2022, the
28moneys shall revert.
294. For field operations:
.................................................. $3031,296,232
315. For general administration:
.................................................. $323,744,000
336. For state child care assistance:
.................................................. $3447,166,826
35a. Of the funds appropriated in this subsection,
-17-1$26,205,412 is transferred to the child care and development
2block grant appropriation made by the Eighty-ninth General
3Assembly, 2021 session, for the federal fiscal year beginning
4October 1, 2021, and ending September 30, 2022. Of this
5amount, $200,000 shall be used for provision of educational
6opportunities to registered child care home providers in order
7to improve services and programs offered by this category
8of providers and to increase the number of providers. The
9department may contract with institutions of higher education
10or child care resource and referral centers to provide
11the educational opportunities. Allowable administrative
12costs under the contracts shall not exceed 5 percent. The
13application for a grant shall not exceed two pages in length.
14b. Any funds appropriated in this subsection remaining
15unallocated shall be used for state child care assistance
16payments for families who are employed including but not
17limited to individuals enrolled in the family investment
18program.
197. For child and family services:
.................................................. $2032,380,654
218. For child abuse prevention grants:
.................................................. $22125,000
239. For pregnancy prevention grants on the condition that
24family planning services are funded:
.................................................. $251,913,203
26Pregnancy prevention grants shall be awarded to programs
27in existence on or before July 1, 2021, if the programs have
28demonstrated positive outcomes. Grants shall be awarded to
29pregnancy prevention programs which are developed after July
301, 2021, if the programs are based on existing models that
31have demonstrated positive outcomes. Grants shall comply with
32the requirements provided in 1997 Iowa Acts, chapter 208,
33section 14, subsections 1 and 2, including the requirement that
34grant programs must emphasize sexual abstinence. Priority in
35the awarding of grants shall be given to programs that serve
-18-1areas of the state which demonstrate the highest percentage of
2unplanned pregnancies of females of childbearing age within the
3geographic area to be served by the grant.
410. For technology needs and other resources necessary to
5meet federal, state, and welfare reform reporting, tracking,
6and case management requirements and other departmental needs:
.................................................. $71,037,186
811. a. Notwithstanding any provision to the contrary,
9including but not limited to requirements in section 8.41 or
10provisions in 2020 Iowa Acts or 2021 Iowa Acts regarding the
11receipt and appropriation of federal block grants, federal
12funds from the temporary assistance for needy families block
13grant received by the state and not otherwise appropriated
14in this section and remaining available for the fiscal year
15beginning July 1, 2021, are appropriated to the department of
16human services to the extent as may be necessary to be used in
17the following priority order: the family investment program,
18for state child care assistance program payments for families
19who are employed, and for the family investment program share
20of system costs for eligibility determination and related
21functions. The federal funds appropriated in this paragraph
22“a” shall be expended only after all other funds appropriated
23in subsection 1 for assistance under the family investment
24program, in subsection 6 for state child care assistance, or
25in subsection 10 for technology costs related to the family
26investment program, as applicable, have been expended. For
27the purposes of this subsection, the funds appropriated in
28subsection 6, paragraph “a”, for transfer to the child care
29and development block grant appropriation are considered fully
30expended when the full amount has been transferred.
31b. The department shall, on a quarterly basis, advise the
32general assembly and department of management of the amount of
33funds appropriated in this subsection that was expended in the
34prior quarter.
3512. Of the amounts appropriated in this section,
-19-1$12,962,008 for the fiscal year beginning July 1, 2021, is
2transferred to the appropriation of the federal social services
3block grant made to the department of human services for that
4fiscal year.
513. For continuation of the program providing categorical
6eligibility for the food assistance program as specified
7for the program in the section of this division of this Act
8relating to the family investment program account:
.................................................. $914,236
1014. The department may transfer funds allocated in this
11section to the appropriations made in this division of this Act
12for the same fiscal year for general administration and field
13operations for resources necessary to implement and operate the
14services referred to in this section and those funded in the
15appropriation made in this division of this Act for the same
16fiscal year for the family investment program from the general
17fund of the state.
1815. With the exception of moneys allocated under this
19section for the family development and self-sufficiency grant
20program, to the extent moneys allocated in this section are
21deemed by the department not to be necessary to support the
22purposes for which they are allocated, such moneys may be used
23in the same fiscal year for any other purpose for which funds
24are allocated in this section or in section 8 of this division
25of this Act for the family investment program account. If
26there are conflicting needs, priority shall first be given
27to the family investment program account as specified under
28subsection 1 of this section and used for the purposes of
29assistance under the family investment program in accordance
30with chapter 239B, followed by state child care assistance
31program payments for families who are employed, followed by
32other priorities as specified by the department.
33 Sec. 8. FAMILY INVESTMENT PROGRAM ACCOUNT.
341. Moneys credited to the family investment program (FIP)
35account for the fiscal year beginning July 1, 2021, and
-20-1ending June 30, 2022, shall be used to provide assistance in
2accordance with chapter 239B.
32. The department may use a portion of the moneys credited
4to the FIP account under this section as necessary for
5salaries, support, maintenance, and miscellaneous purposes.
63. The department may transfer funds allocated in
7subsection 4, excluding the allocation under subsection 4,
8paragraph “b”, to the appropriations made in this division of
9this Act for the same fiscal year for general administration
10and field operations for resources necessary to implement
11and operate the services referred to in this section and
12those funded in the appropriations made in section 7 for the
13temporary assistance for needy families block grant and in
14section 9 for the family investment program from the general
15fund of the state in this division of this Act for the same
16fiscal year.
174. Moneys appropriated in this division of this Act and
18credited to the FIP account for the fiscal year beginning July
191, 2021, and ending June 30, 2022, are allocated as follows:
20a. To be retained by the department of human services to
21be used for coordinating with the department of human rights
22to more effectively serve participants in FIP and other shared
23clients and to meet federal reporting requirements under the
24federal temporary assistance for needy families block grant:
.................................................. $2510,000
26b. To the department of human rights for staffing,
27administration, and implementation of the family development
28and self-sufficiency grant program in accordance with section
29216A.107:
.................................................. $307,192,834
31(1) Of the funds allocated for the family development
32and self-sufficiency grant program in this paragraph “b”,
33not more than 5 percent of the funds shall be used for the
34administration of the grant program.
35(2) The department of human rights may continue to implement
-21-1the family development and self-sufficiency grant program
2statewide during fiscal year 2021-2022.
3(3) The department of human rights may engage in activities
4to strengthen and improve family outcomes measures and
5data collection systems under the family development and
6self-sufficiency grant program.
7c. For the diversion subaccount of the FIP account:
.................................................. $81,293,000
9A portion of the moneys allocated for the diversion
10subaccount may be used for field operations, salaries, data
11management system development, and implementation costs and
12support deemed necessary by the director of human services
13in order to administer the FIP diversion program. To the
14extent moneys allocated in this paragraph “c” are deemed by the
15department not to be necessary to support diversion activities,
16such moneys may be used for other efforts intended to increase
17engagement by family investment program participants in work,
18education, or training activities, or for the purposes of
19assistance under the family investment program in accordance
20with chapter 239B.
21d. For the food assistance employment and training program:
.................................................. $2266,588
23(1) The department shall apply the federal supplemental
24nutrition assistance program (SNAP) employment and training
25state plan in order to maximize to the fullest extent permitted
26by federal law the use of the 50 percent federal reimbursement
27provisions for the claiming of allowable federal reimbursement
28funds from the United States department of agriculture
29pursuant to the federal SNAP employment and training program
30for providing education, employment, and training services
31for eligible food assistance program participants, including
32but not limited to related dependent care and transportation
33expenses.
34(2) The department shall continue the categorical federal
35food assistance program eligibility at 160 percent of the
-22-1federal poverty level and continue to eliminate the asset test
2from eligibility requirements, consistent with federal food
3assistance program requirements. The department shall include
4as many food assistance households as is allowed by federal
5law. The eligibility provisions shall conform to all federal
6requirements including requirements addressing individuals who
7are incarcerated or otherwise ineligible.
8e. For the JOBS program, not more than:
.................................................. $912,018,258
105. Of the child support collections assigned under FIP,
11an amount equal to the federal share of support collections
12shall be credited to the child support recovery appropriation
13made in this division of this Act. Of the remainder of the
14assigned child support collections received by the child
15support recovery unit, a portion shall be credited to the FIP
16account, a portion may be used to increase recoveries, and a
17portion may be used to sustain cash flow in the child support
18payments account. If as a consequence of the appropriations
19and allocations made in this section the resulting amounts
20are insufficient to sustain cash assistance payments and meet
21federal maintenance of effort requirements, the department
22shall seek supplemental funding. If child support collections
23assigned under FIP are greater than estimated or are otherwise
24determined not to be required for maintenance of effort, the
25state share of either amount may be transferred to or retained
26in the child support payments account.
27 Sec. 9. FAMILY INVESTMENT PROGRAM GENERAL FUND. There
28is appropriated from the general fund of the state to the
29department of human services for the fiscal year beginning July
301, 2021, and ending June 30, 2022, the following amount, or
31so much thereof as is necessary, to be used for the purpose
32designated:
33To be credited to the family investment program (FIP)
34account and used for family investment program assistance
35under chapter 239B and other costs associated with providing
-23-1needs-based benefits or assistance:
.................................................. $241,003,978
31. Of the funds appropriated in this section, $6,606,198 is
4allocated for the JOBS program.
52. Of the funds appropriated in this section, $4,313,854 is
6allocated for the family development and self-sufficiency grant
7program.
83. a. Notwithstanding section 8.39, for the fiscal
9year beginning July 1, 2021, if necessary to meet federal
10maintenance of effort requirements or to transfer federal
11temporary assistance for needy families block grant funding
12to be used for purposes of the federal social services block
13grant or to meet cash flow needs resulting from delays in
14receiving federal funding or to implement, in accordance with
15this division of this Act, activities currently funded with
16juvenile court services, county, or community moneys and state
17moneys used in combination with such moneys; to comply with
18federal requirements; or to maximize the use of federal funds;
19the department of human services may transfer funds within or
20between any of the appropriations made in this division of this
21Act and appropriations in law for the federal social services
22block grant to the department for the following purposes,
23provided that the combined amount of state and federal
24temporary assistance for needy families block grant funding
25for each appropriation remains the same before and after the
26transfer:
27(1) For the family investment program.
28(2) For state child care assistance.
29(3) For child and family services.
30(4) For field operations.
31(5) For general administration.
32b. This subsection shall not be construed to prohibit the
33use of existing state transfer authority for other purposes.
34The department shall report any transfers made pursuant to this
35subsection to the general assembly.
-24- 14. Of the funds appropriated in this section, $195,000
2shall be used for a contract for tax preparation assistance
3to low-income Iowans to expand the usage of the earned income
4tax credit. The purpose of the contract is to supply this
5assistance to underserved areas of the state. The department
6shall not retain any portion of the allocation under this
7subsection for administrative costs.
85. Of the funds appropriated in this section, $70,000 shall
9be used for the continuation of the parenting program, as
10specified in 441 IAC ch.100, relating to parental obligations,
11in which the child support recovery unit participates, to
12support the efforts of a nonprofit organization committed to
13strengthening the community through youth development, healthy
14living, and social responsibility headquartered in a county
15with a population over 350,000 according to the 2010 certified
16federal census. The funds allocated in this subsection shall
17be used by the recipient organization to develop a larger
18community effort, through public and private partnerships, to
19support a broad-based multi-county parenthood initiative that
20promotes payment of child support obligations, improved family
21relationships, and full-time employment.
226. The department may transfer funds appropriated in this
23section, excluding the allocation in subsection 2 for the
24family development and self-sufficiency grant program, to the
25appropriations made in this division of this Act for general
26administration and field operations as necessary to administer
27this section, section 7 for the temporary assistance for needy
28families block grant, and section 8 for the family investment
29program account.
30 Sec. 10. CHILD SUPPORT RECOVERY. There is appropriated
31from the general fund of the state to the department of human
32services for the fiscal year beginning July 1, 2021, and ending
33June 30, 2022, the following amount, or so much thereof as is
34necessary, to be used for the purposes designated:
35For child support recovery, including salaries, support,
-25-1maintenance, and miscellaneous purposes, and for not more than
2the following full-time equivalent positions:
.................................................. $315,942,885
............................................... FTEs4459.00
51. The department shall expend up to $24,000, including
6federal financial participation, for the fiscal year beginning
7July 1, 2021, for a child support public awareness campaign.
8The department and the office of the attorney general shall
9cooperate in continuation of the campaign. The public
10awareness campaign shall emphasize, through a variety of
11media activities, the importance of maximum involvement of
12both parents in the lives of their children as well as the
13importance of payment of child support obligations.
142. Federal access and visitation grant moneys shall be
15issued directly to private not-for-profit agencies that provide
16services designed to increase compliance with the child access
17provisions of court orders, including but not limited to
18neutral visitation sites and mediation services.
193. The appropriation made to the department for child
20support recovery may be used throughout the fiscal year in the
21manner necessary for purposes of cash flow management, and for
22cash flow management purposes the department may temporarily
23draw more than the amount appropriated, provided the amount
24appropriated is not exceeded at the close of the fiscal year.
25 Sec. 11. HEALTH CARE TRUST FUND — MEDICAL ASSISTANCE —
26FY 2021-2022. Any funds remaining in the health care trust
27fund created in section 453A.35A for the fiscal year beginning
28July 1, 2021, and ending June 30, 2022, are appropriated to
29the department of human services to supplement the medical
30assistance program appropriations made in this division of this
31Act, for medical assistance reimbursement and associated costs,
32including program administration and costs associated with
33program implementation.
34 Sec. 12. MEDICAID FRAUD FUND — MEDICAL ASSISTANCE — FY
352021-2022. Any funds remaining in the Medicaid fraud fund
-26-1created in section 249A.50 for the fiscal year beginning
2July 1, 2021, and ending June 30, 2022, are appropriated to
3the department of human services to supplement the medical
4assistance appropriations made in this division of this Act,
5for medical assistance reimbursement and associated costs,
6including program administration and costs associated with
7program implementation.
8 Sec. 13. MEDICAL ASSISTANCE. There is appropriated from the
9general fund of the state to the department of human services
10for the fiscal year beginning July 1, 2021, and ending June 30,
112022, the following amount, or so much thereof as is necessary,
12to be used for the purpose designated:
13For medical assistance program reimbursement and associated
14costs as specifically provided in the reimbursement
15methodologies in effect on June 30, 2021, except as otherwise
16expressly authorized by law, consistent with options under
17federal law and regulations, and contingent upon receipt of
18approval from the office of the governor of reimbursement for
19each abortion performed under the program:
.................................................. $201,503,848,253
211. Iowans support reducing the number of abortions
22performed in our state. Funds appropriated under this section
23shall not be used for abortions, unless otherwise authorized
24under this section.
252. The provisions of this section relating to abortions
26shall also apply to the Iowa health and wellness plan created
27pursuant to chapter 249N.
283. The department shall utilize not more than $60,000 of
29the funds appropriated in this section to continue the AIDS/HIV
30health insurance premium payment program as established in 1992
31Iowa Acts, Second Extraordinary Session, chapter 1001, section
32409, subsection 6. Of the funds allocated in this subsection,
33not more than $5,000 may be expended for administrative
34purposes.
354. Of the funds appropriated in this Act to the department
-27-1of public health for addictive disorders, $950,000 for
2the fiscal year beginning July 1, 2021, is transferred
3to the department of human services for an integrated
4substance-related disorder managed care system. The
5departments of human services and public health shall
6work together to maintain the level of mental health and
7substance-related disorder treatment services provided by the
8managed care contractors. Each department shall take the steps
9necessary to continue the federal waivers as necessary to
10maintain the level of services.
115. The department shall aggressively pursue options for
12providing medical assistance or other assistance to individuals
13with special needs who become ineligible to continue receiving
14services under the early and periodic screening, diagnostic,
15and treatment program under the medical assistance program
16due to becoming 21 years of age who have been approved for
17additional assistance through the department’s exception to
18policy provisions, but who have health care needs in excess
19of the funding available through the exception to policy
20provisions.
216. Of the funds appropriated in this section, up to
22$3,050,082 may be transferred to the field operations or
23general administration appropriations in this division of this
24Act for operational costs associated with Part D of the federal
25Medicare Prescription Drug Improvement and Modernization Act
26of 2003, Pub.L.No.108-173.
277. Of the funds appropriated in this section, up to $442,100
28may be transferred to the appropriation in this division of
29this Act for health program operations to be used for clinical
30assessment services and prior authorization of services.
318. A portion of the funds appropriated in this section may
32be transferred to the appropriations in this division of this
33Act for general administration, health program operations, the
34children’s health insurance program, or field operations to be
35used for the state match cost to comply with the payment error
-28-1rate measurement (PERM) program for both the medical assistance
2and children’s health insurance programs as developed by the
3centers for Medicare and Medicaid services of the United States
4department of health and human services to comply with the
5federal Improper Payments Information Act of 2002, Pub.L.
6No.107-300, and to support other reviews and quality control
7activities to improve the integrity of these programs.
89. Of the funds appropriated in this section, a sufficient
9amount is allocated to supplement the incomes of residents of
10nursing facilities, intermediate care facilities for persons
11with mental illness, and intermediate care facilities for
12persons with an intellectual disability, with incomes of less
13than $50 in the amount necessary for the residents to receive a
14personal needs allowance of $50 per month pursuant to section
15249A.30A.
1610. a. Hospitals that meet the conditions specified
17in subparagraphs (1) and (2) shall either certify public
18expenditures or transfer to the medical assistance program
19an amount equal to provide the nonfederal share for a
20disproportionate share hospital payment in an amount up to the
21hospital-specific limit as approved in the Medicaid state plan.
22The hospitals that meet the conditions specified shall receive
23and retain 100 percent of the total disproportionate share
24hospital payment in an amount up to the hospital-specific limit
25as approved in the Medicaid state plan.
26(1) The hospital qualifies for disproportionate share and
27graduate medical education payments.
28(2) The hospital is an Iowa state-owned hospital with more
29than 500 beds and eight or more distinct residency specialty
30or subspecialty programs recognized by the American college of
31graduate medical education.
32b. Distribution of the disproportionate share payments
33shall be made on a monthly basis. The total amount of
34disproportionate share payments including graduate medical
35education, enhanced disproportionate share, and Iowa
-29-1state-owned teaching hospital payments shall not exceed the
2amount of the state’s allotment under Pub.L.No.102-234.
3In addition, the total amount of all disproportionate
4share payments shall not exceed the hospital-specific
5disproportionate share limits under Pub.L.No.103-66.
611. One hundred percent of the nonfederal share of payments
7to area education agencies that are medical assistance
8providers for medical assistance-covered services provided to
9medical assistance-covered children, shall be made from the
10appropriation made in this section.
1112. A portion of the funds appropriated in this section may
12be transferred to the appropriation in this division of this
13Act for health program operations to be used for administrative
14activities associated with the money follows the person
15demonstration project.
1613. Of the funds appropriated in this section, $349,011
17shall be used for the administration of the health insurance
18premium payment program, including salaries, support,
19maintenance, and miscellaneous purposes.
2014. a. The department may increase the amounts allocated
21for salaries, support, maintenance, and miscellaneous purposes
22associated with the medical assistance program, as necessary,
23to sustain cost management efforts. The department shall
24report any such increase to the general assembly and the
25department of management.
26b. If the savings to the medical assistance program from
27ongoing cost management efforts exceed the associated cost
28for the fiscal year beginning July 1, 2021, the department
29may transfer any savings generated for the fiscal year due
30to medical assistance program cost management efforts to the
31appropriation made in this division of this Act for health
32program operations or general administration to defray the
33costs associated with implementing the efforts.
3415. For the fiscal year beginning July 1, 2021, and ending
35June 30, 2022, the replacement generation tax revenues required
-30-1to be deposited in the property tax relief fund pursuant to
2section 437A.8, subsection 4, paragraph “d”, and section
3437A.15, subsection 3, paragraph “f”, shall instead be credited
4to and supplement the appropriation made in this section and
5used for the allocations made in this section.
616. a. Of the funds appropriated in this section, up
7to $50,000 may be transferred by the department to the
8appropriation made in this division of this Act to the
9department for the same fiscal year for general administration
10to be used for associated administrative expenses and for not
11more than 1.00 full-time equivalent position, in addition to
12those authorized for the same fiscal year, to be assigned to
13implementing the children’s mental health home project.
14b. Of the funds appropriated in this section, up to $400,000
15may be transferred by the department to the appropriation made
16to the department in this division of this Act for the same
17fiscal year for Medicaid program-related general administration
18planning and implementation activities. The funds may be used
19for contracts or for personnel in addition to the amounts
20appropriated for and the positions authorized for general
21administration for the fiscal year.
22c. Of the funds appropriated in this section, up to
23$3,000,000 may be transferred by the department to the
24appropriations made in this division of this Act for the
25same fiscal year for general administration or health
26program operations to be used to support the development
27and implementation of standardized assessment tools for
28persons with mental illness, an intellectual disability, a
29developmental disability, or a brain injury.
3017. Of the funds appropriated in this section, $150,000
31shall be used for lodging expenses associated with care
32provided at the university of Iowa hospitals and clinics for
33patients with cancer whose travel distance is 30 miles or more
34and whose income is at or below 200 percent of the federal
35poverty level as defined by the most recently revised poverty
-31-1income guidelines published by the United States department of
2health and human services. The department of human services
3shall establish the maximum number of overnight stays and the
4maximum rate reimbursed for overnight lodging, which may be
5based on the state employee rate established by the department
6of administrative services. The funds allocated in this
7subsection shall not be used as nonfederal share matching
8funds.
918. Of the funds appropriated in this section, up to
10$3,383,880 shall be used for administration of the state family
11planning services program pursuant to section 217.41B, and
12of this amount, the department may use up to $200,000 for
13administrative expenses.
1419. Of the funds appropriated in this section, $1,545,530
15shall be used and may be transferred to other appropriations
16in this division of this Act as necessary to administer the
17provisions in the division of this Act relating to Medicaid
18program administration.
1920. The department shall comply with the centers for
20Medicare and Medicaid services’ guidance related to Medicaid
21program and children’s health insurance program maintenance
22of effort provisions, including eligibility standards,
23methodologies, procedures, and continuous enrollment, to
24receive the enhanced federal medical assistance percentage
25under section 6008(b) of the federal Families First Coronavirus
26Response Act, Pub.L. No.116-127. The department shall
27utilize and implement all tools, processes, and resources
28available to expediently return to normal eligibility and
29enrollment operations in compliance with federal guidance and
30expectations.
3121. Of the funds appropriated in this section, up to
32$1,031,530 shall be used to implement reductions in the waiting
33list for the children’s mental health home and community-based
34services waiver.
3522. Of the funds appropriated in this section, a sufficient
-32-1amount is allocated to fund up to three full-time equivalent
2positions to support the administrative work associated with
3existing and potential supplemental payment programs.
4 Sec. 14. HEALTH PROGRAM OPERATIONS. There is appropriated
5from the general fund of the state to the department of human
6services for the fiscal year beginning July 1, 2021, and ending
7June 30, 2022, the following amount, or so much thereof as is
8necessary, to be used for the purpose designated:
9For health program operations:
.................................................. $1017,831,343
111. The department of inspections and appeals shall
12provide all state matching funds for survey and certification
13activities performed by the department of inspections
14and appeals. The department of human services is solely
15responsible for distributing the federal matching funds for
16such activities.
172. Of the funds appropriated in this section, $50,000 shall
18be used for continuation of home and community-based services
19waiver quality assurance programs, including the review and
20streamlining of processes and policies related to oversight and
21quality management to meet state and federal requirements.
223. Of the amount appropriated in this section, up to
23$200,000 may be transferred to the appropriation for general
24administration in this division of this Act to be used for
25additional full-time equivalent positions in the development
26of key health initiatives such as development and oversight
27of managed care programs and development of health strategies
28targeted toward improved quality and reduced costs in the
29Medicaid program.
304. Of the funds appropriated in this section, $1,000,000
31shall be used for planning and development, in cooperation with
32the department of public health, of a phased-in program to
33provide a dental home for children.
345. a. Of the funds appropriated in this section, $573,000
35shall be credited to the autism support program fund created
-33-1in section 225D.2 to be used for the autism support program
2created in chapter 225D, with the exception of the following
3amount of this allocation which shall be used as follows:
4b. Of the funds allocated in this subsection, $25,000 shall
5be used for the public purpose of continuation of a grant to
6a nonprofit provider of child welfare services that has been
7in existence for more than 115 years, is located in a county
8with a population between 200,000 and 220,000 according to the
92010 federal decennial census, is licensed as a psychiatric
10medical institution for children, and provides school-based
11programming, to be used for support services for children with
12autism spectrum disorder and their families.
13 Sec. 15. STATE SUPPLEMENTARY ASSISTANCE.
141. There is appropriated from the general fund of the
15state to the department of human services for the fiscal year
16beginning July 1, 2021, and ending June 30, 2022, the following
17amount, or so much thereof as is necessary, to be used for the
18purpose designated:
19For the state supplementary assistance program:
.................................................. $207,349,002
212. The department shall increase the personal needs
22allowance for residents of residential care facilities by the
23same percentage and at the same time as federal supplemental
24security income and federal social security benefits are
25increased due to a recognized increase in the cost of living.
26The department may adopt emergency rules to implement this
27subsection.
283. If during the fiscal year beginning July 1, 2021,
29the department projects that state supplementary assistance
30expenditures for a calendar year will not meet the federal
31pass-through requirement specified in Tit.XVI of the federal
32Social Security Act, section 1618, as codified in 42 U.S.C.
33§1382g, the department may take actions including but not
34limited to increasing the personal needs allowance for
35residential care facility residents and making programmatic
-34-1adjustments or upward adjustments of the residential care
2facility or in-home health-related care reimbursement rates
3prescribed in this division of this Act to ensure that federal
4requirements are met. In addition, the department may make
5other programmatic and rate adjustments necessary to remain
6within the amount appropriated in this section while ensuring
7compliance with federal requirements. The department may adopt
8emergency rules to implement the provisions of this subsection.
94. Notwithstanding section 8.33, moneys appropriated
10in this section that remain unencumbered or unobligated
11at the close of the fiscal year shall not revert but
12shall remain available for expenditure for the purposes
13designated, including for liability amounts associated with the
14supplemental nutrition assistance program payment error rate,
15until the close of the succeeding fiscal year.
16 Sec. 16. CHILDREN’S HEALTH INSURANCE PROGRAM.
171. There is appropriated from the general fund of the
18state to the department of human services for the fiscal year
19beginning July 1, 2021, and ending June 30, 2022, the following
20amount, or so much thereof as is necessary, to be used for the
21purpose designated:
22For maintenance of the healthy and well kids in Iowa (hawk-i)
23program pursuant to chapter 514I, including supplemental dental
24services, for receipt of federal financial participation under
25Tit.XXI of the federal Social Security Act, which creates the
26children’s health insurance program:
.................................................. $2737,957,643
282. Of the funds appropriated in this section, $149,189 is
29allocated for continuation of the contract for outreach with
30the department of public health.
313. A portion of the funds appropriated in this section may
32be transferred to the appropriations made in this division of
33this Act for field operations or health program operations to
34be used for the integration of hawk-i program eligibility,
35payment, and administrative functions under the purview of
-35-1the department of human services, including for the Medicaid
2management information system upgrade.
3 Sec. 17. CHILD CARE ASSISTANCE. There is appropriated
4from the general fund of the state to the department of human
5services for the fiscal year beginning July 1, 2021, and ending
6June 30, 2022, the following amount, or so much thereof as is
7necessary, to be used for the purpose designated:
8For child care programs:
.................................................. $940,816,931
101. Of the funds appropriated in this section, $34,966,931
11shall be used for state child care assistance in accordance
12with section 237A.13.
132. Nothing in this section shall be construed or is
14intended as or shall imply a grant of entitlement for services
15to persons who are eligible for assistance due to an income
16level consistent with the waiting list requirements of section
17237A.13. Any state obligation to provide services pursuant to
18this section is limited to the extent of the funds appropriated
19in this section.
203. A list of the registered and licensed child care
21facilities operating in the area served by a child care
22resource and referral service shall be made available to the
23families receiving state child care assistance in that area.
244. Of the funds appropriated in this section, $5,850,000
25shall be credited to the early childhood programs grants
26account in the early childhood Iowa fund created in section
27256I.11. The moneys shall be distributed for funding of
28community-based early childhood programs targeted to children
29from birth through five years of age developed by early
30childhood Iowa areas in accordance with approved community
31plans as provided in section 256I.8.
325. The department may use any of the funds appropriated
33in this section as a match to obtain federal funds for use in
34expanding child care assistance and related programs. For
35the purpose of expenditures of state and federal child care
-36-1funding, funds shall be considered obligated at the time
2expenditures are projected or are allocated to the department’s
3service areas. Projections shall be based on current and
4projected caseload growth, current and projected provider
5rates, staffing requirements for eligibility determination
6and management of program requirements including data systems
7management, staffing requirements for administration of the
8program, contractual and grant obligations and any transfers
9to other state agencies, and obligations for decategorization
10or innovation projects.
116. A portion of the state match for the federal child care
12and development block grant shall be provided as necessary to
13meet federal matching funds requirements through the state
14general fund appropriation made for child development grants
15and other programs for at-risk children in section 279.51.
167. If a uniform reduction ordered by the governor under
17section 8.31 or other operation of law, transfer, or federal
18funding reduction reduces the appropriation made in this
19section for the fiscal year, the percentage reduction in the
20amount paid out to or on behalf of the families participating
21in the state child care assistance program shall be equal to or
22less than the percentage reduction made for any other purpose
23payable from the appropriation made in this section and the
24federal funding relating to it. The percentage reduction to
25the other allocations made in this section shall be the same as
26the uniform reduction ordered by the governor or the percentage
27change of the federal funding reduction, as applicable. If
28there is an unanticipated increase in federal funding provided
29for state child care services, the entire amount of the
30increase, except as necessary to meet federal requirements
31including quality set asides, shall be used for state child
32care assistance payments. If the appropriations made for
33purposes of the state child care assistance program for the
34fiscal year are determined to be insufficient, it is the intent
35of the general assembly to appropriate sufficient funding for
-37-1the fiscal year in order to avoid establishment of waiting list
2requirements.
38. Notwithstanding section 8.33, moneys advanced for
4purposes of the programs developed by early childhood Iowa
5areas, advanced for purposes of wraparound child care, or
6received from the federal appropriations made for the purposes
7of this section that remain unencumbered or unobligated at the
8close of the fiscal year shall not revert to any fund but shall
9remain available for expenditure for the purposes designated
10until the close of the succeeding fiscal year.
11 Sec. 18. JUVENILE INSTITUTION. There is appropriated
12from the general fund of the state to the department of human
13services for the fiscal year beginning July 1, 2021, and ending
14June 30, 2022, the following amounts, or so much thereof as is
15necessary, to be used for the purposes designated:
161. a. For operation of the state training school at Eldora
17and for salaries, support, maintenance, and miscellaneous
18purposes, and for not more than the following full-time
19equivalent positions:
.................................................. $2017,397,068
............................................... FTEs21207.00
22b. Of the funds appropriated in this subsection, $91,000
23shall be used for distribution to licensed classroom teachers
24at this and other institutions under the control of the
25department of human services based upon the average student
26yearly enrollment at each institution as determined by the
27department.
282. A portion of the moneys appropriated in this section
29shall be used by the state training school at Eldora for
30grants for adolescent pregnancy prevention activities at the
31institution in the fiscal year beginning July 1, 2021.
323. Of the funds appropriated in this subsection, $212,000
33shall be used by the state training school at Eldora for a
34substance use disorder treatment program at the institution for
35the fiscal year beginning July 1, 2021.
-38- 14. Notwithstanding section 8.33, moneys appropriated in
2this section that remain unencumbered or unobligated at the
3close of the fiscal year shall not revert but shall remain
4available for expenditure for the purposes designated until the
5close of the succeeding fiscal year.
6 Sec. 19. CHILD AND FAMILY SERVICES.
71. There is appropriated from the general fund of the
8state to the department of human services for the fiscal year
9beginning July 1, 2021, and ending June 30, 2022, the following
10amount, or so much thereof as is necessary, to be used for the
11purpose designated:
12For child and family services:
.................................................. $1389,071,930
142. The department may transfer funds appropriated in this
15section as necessary to pay the nonfederal costs of services
16reimbursed under the medical assistance program, state child
17care assistance program, or the family investment program which
18are provided to children who would otherwise receive services
19paid under the appropriation in this section. The department
20may transfer funds appropriated in this section to the
21appropriations made in this division of this Act for general
22administration and for field operations for resources necessary
23to implement and operate the services funded in this section.
243. a. Of the funds appropriated in this section, up to
25$31,500,000 is allocated as the statewide expenditure target
26under section 232.143 for group foster care maintenance and
27services. If the department projects that such expenditures
28for the fiscal year will be less than the target amount
29allocated in this paragraph “a”, the department may reallocate
30the excess to provide additional funding for family foster
31care, independent living, family-centered services, shelter
32care, or the child welfare emergency services addressed with
33the allocation for shelter care.
34b. If at any time after September 30, 2021, annualization
35of a service area’s current expenditures indicates a service
-39-1area is at risk of exceeding its group foster care expenditure
2target under section 232.143 by more than 5 percent, the
3department and juvenile court services shall examine all
4group foster care placements in that service area in order to
5identify those which might be appropriate for termination.
6In addition, any aftercare services believed to be needed
7for the children whose placements may be terminated shall be
8identified. The department and juvenile court services shall
9initiate action to set dispositional review hearings for the
10placements identified. In such a dispositional review hearing,
11the juvenile court shall determine whether needed aftercare
12services are available and whether termination of the placement
13is in the best interest of the child and the community.
144. In accordance with the provisions of section 232.188,
15the department shall continue the child welfare and juvenile
16justice funding initiative during fiscal year 2021-2022. Of
17the funds appropriated in this section, $1,717,000 is allocated
18specifically for expenditure for fiscal year 2021-2022 through
19the decategorization services funding pools and governance
20boards established pursuant to section 232.188.
215. A portion of the funds appropriated in this section
22may be used for emergency family assistance to provide other
23resources required for a family participating in a family
24preservation or reunification project or successor project to
25stay together or to be reunified.
266. Of the funds appropriated in this section, a sufficient
27amount is allocated for shelter care and the child welfare
28emergency services contracting implemented to provide for or
29prevent the need for shelter care.
307. Federal funds received by the state during the fiscal
31year beginning July 1, 2021, as the result of the expenditure
32of state funds appropriated during a previous state fiscal
33year for a service or activity funded under this section are
34appropriated to the department to be used as additional funding
35for services and purposes provided for under this section.
-40-1Notwithstanding section 8.33, moneys received in accordance
2with this subsection that remain unencumbered or unobligated at
3the close of the fiscal year shall not revert to any fund but
4shall remain available for the purposes designated until the
5close of the succeeding fiscal year.
68. a. Of the funds appropriated in this section, up to
7$3,290,000 is allocated for the payment of the expenses of
8court-ordered services provided to juveniles who are under the
9supervision of juvenile court services, which expenses are a
10charge upon the state pursuant to section 232.141, subsection
114. Of the amount allocated in this paragraph “a”, up to
12$1,556,000 shall be made available to provide school-based
13supervision of children adjudicated under chapter 232, of which
14not more than $15,000 may be used for the purpose of training.
15A portion of the cost of each school-based liaison officer
16shall be paid by the school district or other funding source as
17approved by the chief juvenile court officer.
18b. Of the funds appropriated in this section, up to $748,000
19is allocated for the payment of the expenses of court-ordered
20services provided to children who are under the supervision
21of the department, which expenses are a charge upon the state
22pursuant to section 232.141, subsection 4.
23c. Notwithstanding section 232.141 or any other provision
24of law to the contrary, the amounts allocated in this
25subsection shall be distributed to the judicial districts
26as determined by the state court administrator and to the
27department’s service areas as determined by the administrator
28of the department of human services’ division of child and
29family services. The state court administrator and the
30division administrator shall make the determination of the
31distribution amounts on or before June 15, 2021.
32d. Notwithstanding chapter 232 or any other provision of
33law to the contrary, a district or juvenile court shall not
34order any service which is a charge upon the state pursuant
35to section 232.141 if there are insufficient court-ordered
-41-1services funds available in the district court or departmental
2service area distribution amounts to pay for the service. The
3chief juvenile court officer and the departmental service area
4manager shall encourage use of the funds allocated in this
5subsection such that there are sufficient funds to pay for
6all court-related services during the entire year. The chief
7juvenile court officers and departmental service area managers
8shall attempt to anticipate potential surpluses and shortfalls
9in the distribution amounts and shall cooperatively request the
10state court administrator or division administrator to transfer
11funds between the judicial districts’ or departmental service
12areas’ distribution amounts as prudent.
13e. Notwithstanding any provision of law to the contrary,
14a district or juvenile court shall not order a county to pay
15for any service provided to a juvenile pursuant to an order
16entered under chapter 232 which is a charge upon the state
17under section 232.141, subsection 4.
18f. Of the funds allocated in this subsection, not more than
19$83,000 may be used by the judicial branch for administration
20of the requirements under this subsection.
21g. Of the funds allocated in this subsection, $17,000
22shall be used by the department of human services to support
23the interstate commission for juveniles in accordance with
24the interstate compact for juveniles as provided in section
25232.173.
269. Of the funds appropriated in this section, $12,253,000 is
27allocated for juvenile delinquent graduated sanctions services.
28Any state funds saved as a result of efforts by juvenile court
29services to earn a federal Tit.IV-E match for juvenile court
30services administration may be used for the juvenile delinquent
31graduated sanctions services.
3210. Of the funds appropriated in this section, $1,658,000 is
33transferred to the department of public health to be used for
34the child protection center grant program for child protection
35centers located in Iowa in accordance with section 135.118.
-42-1The grant amounts under the program shall be equalized so that
2each center receives a uniform base amount of $245,000, and so
3that the remaining funds are awarded through a funding formula
4based upon the volume of children served. To increase access
5to child protection center services for children in rural
6areas, the funding formula for the awarding of the remaining
7funds shall provide for the awarding of an enhanced amount to
8eligible grantees to develop and maintain satellite centers in
9underserved regions of the state.
1011. Of the funds appropriated in this section, $4,025,000 is
11allocated for the preparation for adult living program pursuant
12to section 234.46.
1312. Of the funds appropriated in this section, $227,000
14shall be used for the public purpose of continuing a grant to a
15nonprofit human services organization, providing services to
16individuals and families in multiple locations in southwest
17Iowa and Nebraska for support of a project providing immediate,
18sensitive support and forensic interviews, medical exams, needs
19assessments, and referrals for victims of child abuse and their
20nonoffending family members.
2113. Of the funds appropriated in this section, $300,000
22is allocated for the foster care youth council approach of
23providing a support network to children placed in foster care.
2414. Of the funds appropriated in this section, $202,000 is
25allocated for use pursuant to section 235A.1 for continuation
26of the initiative to address child sexual abuse implemented
27pursuant to 2007 Iowa Acts, chapter 218, section 18, subsection
2821.
2915. Of the funds appropriated in this section, $630,000 is
30allocated for the community partnership for child protection
31sites.
3216. Of the funds appropriated in this section, $371,000
33is allocated for the department’s minority youth and family
34projects under the redesign of the child welfare system.
3517. Of the funds appropriated in this section, $851,000
-43-1is allocated for funding of the community circle of care
2collaboration for children and youth in northeast Iowa.
318. Of the funds appropriated in this section, at least
4$147,000 shall be used for the continuation of the child
5welfare provider training academy, a collaboration between the
6coalition for family and children’s services in Iowa and the
7department.
819. Of the funds appropriated in this section, $211,000
9shall be used for continuation of the central Iowa system of
10care program grant for the purposes of funding community-based
11services and other supports with a system of care approach for
12children with serious emotional disturbance and their families
13through a nonprofit provider that is located in a county
14with a population of more than 420,000 but less than 450,000
15according to the 2010 certified federal census, is licensed
16as a psychiatric medical institution for children, and was a
17system of care grantee prior to July 1, 2021.
1820. Of the funds appropriated in this section, $235,000
19shall be used for the public purpose of the continuation
20and expansion of a system of care program grant implemented
21in Cerro Gordo and Linn counties to utilize a comprehensive
22and long-term approach for helping children and families by
23addressing the key areas in a child’s life of childhood basic
24needs, education and work, family, and community.
2521. Of the funds appropriated in this section, $110,000
26shall be used for the public purpose of funding community-based
27services and other supports with a system of care approach
28for children with a serious emotional disturbance and their
29families through a nonprofit provider of child welfare services
30that has been in existence for more than 115 years, is located
31in a county with a population of more than 200,000 but less
32than 220,000 according to the 2010 certified federal census, is
33licensed as a psychiatric medical institution for children, and
34was a system of care grantee prior to July 1, 2021.
3522. If a separate funding source is identified that reduces
-44-1the need for state funds within an allocation under this
2section, the allocated state funds may be redistributed to
3other allocations under this section for the same fiscal year.
423. Of the funds appropriated in this section, a portion may
5be used for family-centered services for purposes of complying
6with the federal Family First Prevention Services Act of 2018,
7Pub.L. No.115-123, and successor legislation.
8 Sec. 20. ADOPTION SUBSIDY.
91. There is appropriated from the general fund of the
10state to the department of human services for the fiscal year
11beginning July 1, 2021, and ending June 30, 2022, the following
12amount, or so much thereof as is necessary, to be used for the
13purpose designated:
14a. For adoption subsidy payments and related costs and for
15other services provided for under paragraph “b”, subparagraph
16(2):
.................................................. $1740,596,007
18b. (1) Of the funds appropriated in this section, a
19sufficient amount is allocated for adoption subsidy payments
20and related costs.
21(2) Any funds appropriated in this section remaining after
22the allocation under subparagraph (1) are designated and
23allocated as state savings resulting from implementation of
24the federal Fostering Connections to Success and Increasing
25Adoptions Act of 2008, Pub.L. No.110-351, and successor
26legislation, as determined in accordance with 42 U.S.C.
27§673(a)(8), and shall be used for post-adoption services and
28for other purposes allowed under these federal laws, Tit.IV-B
29or Tit.IV-E of the federal Social Security Act.
30(a) The department of human services may transfer funds
31allocated in this subparagraph (2) to the appropriation for
32child and family services in this division of this Act for the
33purposes designated in this subparagraph (2).
34(b) Notwithstanding section 8.33, moneys allocated
35under this subparagraph (2) shall not revert to any fund but
-45-1shall remain available for the purposes designated in this
2subparagraph (2) until expended.
32. The department may transfer funds appropriated in
4this section to the appropriation made in this division of
5this Act for general administration for costs paid from the
6appropriation relating to adoption subsidy.
73. Federal funds received by the state during the
8fiscal year beginning July 1, 2021, as the result of the
9expenditure of state funds during a previous state fiscal
10year for a service or activity funded under this section are
11appropriated to the department to be used as additional funding
12for the services and activities funded under this section.
13Notwithstanding section 8.33, moneys received in accordance
14with this subsection that remain unencumbered or unobligated
15at the close of the fiscal year shall not revert to any fund
16but shall remain available for expenditure for the purposes
17designated until the close of the succeeding fiscal year.
18 Sec. 21. JUVENILE DETENTION HOME FUND. Moneys deposited
19in the juvenile detention home fund created in section 232.142
20during the fiscal year beginning July 1, 2021, and ending June
2130, 2022, are appropriated to the department of human services
22for the fiscal year beginning July 1, 2021, and ending June 30,
232022, for distribution of an amount equal to a percentage of
24the costs of the establishment, improvement, operation, and
25maintenance of county or multicounty juvenile detention homes
26in the fiscal year beginning July 1, 2020. Moneys appropriated
27for distribution in accordance with this section shall be
28allocated among eligible detention homes, prorated on the basis
29of an eligible detention home’s proportion of the costs of all
30eligible detention homes in the fiscal year beginning July
311, 2020. The percentage figure shall be determined by the
32department based on the amount available for distribution for
33the fund. Notwithstanding section 232.142, subsection 3, the
34financial aid payable by the state under that provision for the
35fiscal year beginning July 1, 2021, shall be limited to the
-46-1amount appropriated for the purposes of this section.
2 Sec. 22. FAMILY SUPPORT SUBSIDY PROGRAM.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2021, and ending June 30, 2022, the following
6amount, or so much thereof as is necessary, to be used for the
7purpose designated:
8For the family support subsidy program subject to the
9enrollment restrictions in section 225C.37, subsection 3:
.................................................. $10949,282
112. At least $899,291 of the moneys appropriated in this
12section is transferred to the department of public health for
13the family support center component of the comprehensive family
14support program under chapter 225C, subchapter V.
153. If at any time during the fiscal year, the amount of
16funding available for the family support subsidy program
17is reduced from the amount initially used to establish the
18figure for the number of family members for whom a subsidy
19is to be provided at any one time during the fiscal year,
20notwithstanding section 225C.38, subsection 2, the department
21shall revise the figure as necessary to conform to the amount
22of funding available.
23 Sec. 23. CONNER DECREE. There is appropriated from the
24general fund of the state to the department of human services
25for the fiscal year beginning July 1, 2021, and ending June 30,
262022, the following amount, or so much thereof as is necessary,
27to be used for the purpose designated:
28For building community capacity through the coordination
29and provision of training opportunities in accordance with the
30consent decree of Conner v.Branstad, No.4-86-CV-30871(S.D.
31Iowa, July 14, 1994):
.................................................. $3233,632
33 Sec. 24. MENTAL HEALTH INSTITUTES.
341. There is appropriated from the general fund of the
35state to the department of human services for the fiscal year
-47-1beginning July 1, 2021, and ending June 30, 2022, the following
2amounts, or so much thereof as is necessary, to be used for the
3purposes designated:
4a. For operation of the state mental health institute at
5Cherokee as required by chapters 218 and 226 for salaries,
6support, maintenance, and miscellaneous purposes, and for not
7more than the following full-time equivalent positions:
.................................................. $815,457,597
............................................... FTEs9169.00
10b. For operation of the state mental health institute at
11Independence as required by chapters 218 and 226 for salaries,
12support, maintenance, and miscellaneous purposes, and for not
13more than the following full-time equivalent positions:
.................................................. $1419,652,379
............................................... FTEs15208.00
162. a. Notwithstanding sections 218.78 and 249A.11, any
17revenue received from the state mental health institute at
18Cherokee or the state mental health institute at Independence
19pursuant to 42 C.F.R§438.6(e) may be retained and expended by
20the mental health institute.
21b. Notwithstanding sections 218.78 and 249A.11, any
22COVID-19 related funding received through federal funding
23sources by the state mental health institute at Cherokee or the
24state mental health institute at Independence may be retained
25and expended by the mental health institute.
263. Notwithstanding any provision of law to the contrary,
27a Medicaid member residing at the state mental health
28institute at Cherokee or the state mental health institute
29at Independence shall retain Medicaid eligibility during
30the period of the Medicaid member’s stay for which federal
31financial participation is available.
324. Notwithstanding section 8.33, moneys appropriated in
33this section that remain unencumbered or unobligated at the
34close of the fiscal year shall not revert but shall remain
35available for expenditure for the purposes designated until the
-48-1close of the succeeding fiscal year.
2 Sec. 25. STATE RESOURCE CENTERS.
31. There is appropriated from the general fund of the
4state to the department of human services for the fiscal year
5beginning July 1, 2021, and ending June 30, 2022, the following
6amounts, or so much thereof as is necessary, to be used for the
7purposes designated:
8a. For the state resource center at Glenwood for salaries,
9support, maintenance, and miscellaneous purposes:
.................................................. $1014,802,873
11b. For the state resource center at Woodward for salaries,
12support, maintenance, and miscellaneous purposes:
.................................................. $1312,237,937
142. The department may continue to bill for state resource
15center services utilizing a scope of services approach used for
16private providers of intermediate care facilities for persons
17with an intellectual disability services, in a manner which
18does not shift costs between the medical assistance program,
19counties, or other sources of funding for the state resource
20centers.
213. The state resource centers may expand the time-limited
22assessment and respite services during the fiscal year.
234. If the department’s administration and the department
24of management concur with a finding by a state resource
25center’s superintendent that projected revenues can reasonably
26be expected to pay the salary and support costs for a new
27employee position, or that such costs for adding a particular
28number of new positions for the fiscal year would be less
29than the overtime costs if new positions would not be added,
30the superintendent may add the new position or positions. If
31the vacant positions available to a resource center do not
32include the position classification desired to be filled, the
33state resource center’s superintendent may reclassify any
34vacant position as necessary to fill the desired position. The
35superintendents of the state resource centers may, by mutual
-49-1agreement, pool vacant positions and position classifications
2during the course of the fiscal year in order to assist one
3another in filling necessary positions.
45. If existing capacity limitations are reached in
5operating units, a waiting list is in effect for a service or
6a special need for which a payment source or other funding
7is available for the service or to address the special need,
8and facilities for the service or to address the special need
9can be provided within the available payment source or other
10funding, the superintendent of a state resource center may
11authorize opening not more than two units or other facilities
12and begin implementing the service or addressing the special
13need during fiscal year 2021-2022.
146. Notwithstanding section 8.33, and notwithstanding
15the amount limitation specified in section 222.92, moneys
16appropriated in this section that remain unencumbered or
17unobligated at the close of the fiscal year shall not revert
18but shall remain available for expenditure for the purposes
19designated until the close of the succeeding fiscal year.
20 Sec. 26. SEXUALLY VIOLENT PREDATORS.
211. There is appropriated from the general fund of the
22state to the department of human services for the fiscal year
23beginning July 1, 2021, and ending June 30, 2022, the following
24amount, or so much thereof as is necessary, to be used for the
25purpose designated:
26For costs associated with the commitment and treatment of
27sexually violent predators in the unit located at the state
28mental health institute at Cherokee, including costs of legal
29services and other associated costs, including salaries,
30support, maintenance, and miscellaneous purposes, and for not
31more than the following full-time equivalent positions:
.................................................. $3213,643,727
............................................... FTEs33139.00
342. Unless specifically prohibited by law, if the amount
35charged provides for recoupment of at least the entire amount
-50-1of direct and indirect costs, the department of human services
2may contract with other states to provide care and treatment
3of persons placed by the other states at the unit for sexually
4violent predators at Cherokee. The moneys received under
5such a contract shall be considered to be repayment receipts
6and used for the purposes of the appropriation made in this
7section.
83. Notwithstanding section 8.33, moneys appropriated in
9this section that remain unencumbered or unobligated at the
10close of the fiscal year shall not revert but shall remain
11available for expenditure for the purposes designated until the
12close of the succeeding fiscal year.
13 Sec. 27. FIELD OPERATIONS.
141. There is appropriated from the general fund of the
15state to the department of human services for the fiscal year
16beginning July 1, 2021, and ending June 30, 2022, the following
17amount, or so much thereof as is necessary, to be used for the
18purposes designated:
19For field operations, including salaries, support,
20maintenance, and miscellaneous purposes, and for not more than
21the following full-time equivalent positions:
.................................................. $2260,596,667
............................................... FTEs231,539.00
242. Priority in filling full-time equivalent positions
25shall be given to those positions related to child protection
26services and eligibility determination for low-income families.
27 Sec. 28. GENERAL ADMINISTRATION. There is appropriated
28from the general fund of the state to the department of human
29services for the fiscal year beginning July 1, 2021, and ending
30June 30, 2022, the following amount, or so much thereof as is
31necessary, to be used for the purpose designated:
32For general administration, including salaries, support,
33maintenance, and miscellaneous purposes, and for not more than
34the following full-time equivalent positions:
.................................................. $3515,342,189
-51-............................................... FTEs1294.00
21. The department shall report at least monthly to the
3general assembly concerning the department’s operational and
4program expenditures.
52. Of the funds appropriated in this section, $150,000 shall
6be used for the provision of a program to provide technical
7assistance, support, and consultation to providers of home and
8community-based services under the medical assistance program.
93. Of the funds appropriated in this section, $50,000
10is transferred to the Iowa finance authority to be used
11for administrative support of the council on homelessness
12established in section 16.2D and for the council to fulfill its
13duties in addressing and reducing homelessness in the state.
144. Of the funds appropriated in this section, $200,000 shall
15be transferred to and deposited in the administrative fund of
16the Iowa ABLE savings plan trust created in section 12I.4, to
17be used for implementation and administration activities of the
18Iowa ABLE savings plan trust.
195. Of the funds appropriated in this section, $200,000 is
20transferred to the economic development authority for the Iowa
21commission on volunteer services to continue to be used for the
22RefugeeRISE AmeriCorps program established under section 15H.8
23for member recruitment and training to improve the economic
24well-being and health of economically disadvantaged refugees in
25local communities across Iowa. Funds transferred may be used
26to supplement federal funds under federal regulations.
276. Of the funds appropriated in this section, up to $300,000
28shall be used as follows:
29a. To fund not more than one full-time equivalent position
30to address the department’s responsibility to support the work
31of the children’s behavioral health system state board and
32implementation of the services required pursuant to section
33331.397.
34b. To support the cost of establishing and implementing new
35or additional services required pursuant to sections 331.397
-52-1and 331.397A.
2c. Of the amount allocated, $32,000 shall be transferred
3to the department of public health to support the costs of
4establishing and implementing new or additional services
5required pursuant to sections 331.397 and 331.397A.
67. Of the funds appropriated in this section, $800,000 shall
7be used for the renovation and construction of certain nursing
8facilities, consistent with the provisions of chapter 249K.
9 Sec. 29. DEPARTMENT-WIDE DUTIES. There is appropriated
10from the general fund of the state to the department of human
11services for the fiscal year beginning July 1, 2021, and ending
12June 30, 2022, the following amount, or so much thereof as is
13necessary, to be used for the purposes designated:
14For salaries, support, maintenance, and miscellaneous
15purposes at facilities under the purview of the department of
16human services:
.................................................. $172,879,274
18 Sec. 30. VOLUNTEERS. There is appropriated from the general
19fund of the state to the department of human services for the
20fiscal year beginning July 1, 2021, and ending June 30, 2022,
21the following amount, or so much thereof as is necessary, to be
22used for the purpose designated:
23For development and coordination of volunteer services:
.................................................. $2484,686
25 Sec. 31. MEDICAL ASSISTANCE, STATE SUPPLEMENTARY
26ASSISTANCE, AND SOCIAL SERVICE PROVIDERS REIMBURSED UNDER THE
27DEPARTMENT OF HUMAN SERVICES.
281. a. (1) (a) Notwithstanding any provision of law to
29the contrary, for the fiscal year beginning July 1, 2021, the
30department shall not rebase case-mix nursing facility rates,
31but shall instead reimburse case-mix nursing facilities by
32adjusting the nursing facility case-mix adjusted rates that
33were effective July 1, 2019, using the mid-points of each of
34the most recent cost reports submitted by the nursing facility
35for the period ending on or before December 31, 2018, and
-53-1inflating these costs forward applying the inflation factor as
2determined using the latest available quarterly publication of
3the HCFA/SNF index, to the extent possible within the state
4funding, including the $19,080,860 provided for this purpose.
5(b) For the fiscal year beginning July 1, 2021, non-case-mix
6and special population nursing facilities shall be reimbursed
7in accordance with the methodology in effect on June 30 of the
8prior fiscal year.
9(c) For managed care claims, the department of human
10services shall adjust the payment rate floor for nursing
11facilities, annually, to maintain a rate floor that is no
12lower than the Medicaid fee-for-service case-mix adjusted rate
13calculated in accordance with subparagraph division (a) and
14441 IAC 81.6. The department shall then calculate adjusted
15reimbursement rates, including but not limited to add-on
16payments, annually, and shall notify Medicaid managed care
17organizations of the adjusted reimbursement rates within 30
18days of determining the adjusted reimbursement rates. Any
19adjustment of reimbursement rates under this subparagraph
20division shall be budget neutral to the state budget.
21(d) For the fiscal year beginning July 1, 2021, Medicaid
22managed care long-term services and supports capitation rates
23shall be adjusted to reflect the case-mix adjusted rates
24specified pursuant to subparagraph division (a) for the patient
25populations residing in Medicaid-certified nursing facilities.
26(2) Medicaid managed care organizations shall adjust
27facility-specific rates based upon payment rate listings issued
28by the department. The rate adjustments shall be applied
29prospectively from the effective date of the rate letter issued
30by the department.
31b. (1) For the fiscal year beginning July 1, 2021,
32contingent upon implementation of the contractual agreements
33with Medicaid managed care organizations as described pursuant
34to subparagraph (2), the department shall establish the
35fee-for-service pharmacy dispensing fee reimbursement at
-54-1$10.38 per prescription, until a cost of dispensing survey is
2completed. The actual dispensing fee shall be determined by
3a cost of dispensing survey performed by the department and
4required to be completed by all medical assistance program
5participating pharmacies every two years. A change in the
6dispensing fee shall become effective following federal
7approval of the Medicaid state plan.
8(2) The department shall amend Medicaid managed care
9organization contracts to authorize establishment of a managed
10care pharmacy dispensing fee reimbursement in accordance with
11either of the following:
12(a) The established fee-for-service pharmacy dispensing
13fee reimbursement per prescription as specified pursuant to
14subparagraph (1).
15(b) A dispensing fee determined contractually by mutual
16agreement between the managed care organization and a
17participating pharmacy with more than thirty locations in
18the state and headquarters located outside the state, not to
19exceed the established fee-for-service pharmacy dispensing
20fee reimbursement per prescription as specified pursuant to
21subparagraph (1).
22(3) The department shall utilize an average acquisition
23cost reimbursement methodology for all drugs covered under the
24medical assistance program in accordance with 2012 Iowa Acts,
25chapter 1133, section 33.
26c. (1) For the fiscal year beginning July 1, 2021,
27reimbursement rates for outpatient hospital services shall
28remain at the rates in effect on June 30, 2021, subject to
29Medicaid program upper payment limit rules, and adjusted
30as necessary to maintain expenditures within the amount
31appropriated to the department for this purpose for the fiscal
32year.
33(2) For the fiscal year beginning July 1, 2021,
34reimbursement rates for inpatient hospital services shall
35be rebased effective October 1, 2021, subject to Medicaid
-55-1program upper payment limit rules, and adjusted as necessary
2to maintain expenditures within the amount appropriated to the
3department for this purpose for the fiscal year.
4(3) For the fiscal year beginning July 1, 2021, under
5both fee-for-service and managed care administration of
6the Medicaid program, critical access hospitals shall be
7reimbursed for inpatient and outpatient services based on the
8hospital-specific critical access hospital cost adjustment
9factor methodology utilizing the most recent and complete cost
10reporting period as applied prospectively within the funds
11appropriated for such purpose for the fiscal year.
12(4) For the fiscal year beginning July 1, 2021, the graduate
13medical education and disproportionate share hospital fund
14shall remain at the amount in effect on June 30, 2021, except
15that the portion of the fund attributable to graduate medical
16education shall be reduced in an amount that reflects the
17elimination of graduate medical education payments made to
18out-of-state hospitals.
19(5) In order to ensure the efficient use of limited state
20funds in procuring health care services for low-income Iowans,
21funds appropriated in this Act for hospital services shall
22not be used for activities which would be excluded from a
23determination of reasonable costs under the federal Medicare
24program pursuant to 42 U.S.C.§1395x(v)(1)(N).
25d. For the fiscal year beginning July 1, 2021, reimbursement
26rates for hospices and acute psychiatric hospitals shall be
27increased in accordance with increases under the federal
28Medicare program or as supported by their Medicare audited
29costs.
30e. For the fiscal year beginning July 1, 2021, independent
31laboratories and rehabilitation agencies shall be reimbursed
32using the same methodology in effect on June 30, 2021.
33f. (1) For the fiscal year beginning July 1, 2021,
34reimbursement rates for home health agencies shall continue to
35be based on the Medicare low utilization payment adjustment
-56-1(LUPA) methodology with state geographic wage adjustments and
2shall be adjusted to increase the rates to the extent possible
3within the state funding, including the $2,000,000 appropriated
4for this purpose. The department shall continue to update the
5rates every two years to reflect the most recent Medicare LUPA
6rates.
7(2) For the fiscal year beginning July 1, 2021, rates for
8private duty nursing and personal care services under the early
9and periodic screening, diagnostic, and treatment program
10benefit shall be calculated based on the methodology in effect
11on June 30, 2021.
12g. For the fiscal year beginning July 1, 2021, federally
13qualified health centers and rural health clinics shall receive
14cost-based reimbursement for 100 percent of the reasonable
15costs for the provision of services to recipients of medical
16assistance.
17h. For the fiscal year beginning July 1, 2021, the
18reimbursement rates for dental services shall remain at the
19rates in effect on June 30, 2021.
20i. (1) For the fiscal year beginning July 1, 2021,
21reimbursement rates for non-state-owned psychiatric medical
22institutions for children shall be increased to the extent
23possible within the $3,900,000 appropriated for this purpose.
24(2) As a condition of participation in the medical
25assistance program, enrolled providers shall accept the medical
26assistance reimbursement rate for any covered goods or services
27provided to recipients of medical assistance who are children
28under the custody of a psychiatric medical institution for
29children.
30j. For the fiscal year beginning July 1, 2021, unless
31otherwise specified in this Act, all noninstitutional medical
32assistance provider reimbursement rates shall remain at the
33rates in effect on June 30, 2021, except for area education
34agencies, local education agencies, infant and toddler
35services providers, home and community-based services providers
-57-1including consumer-directed attendant care providers under a
2section 1915(c) or 1915(i) waiver, targeted case management
3providers, and those providers whose rates are required to be
4determined pursuant to section 249A.20, or to meet federal
5mental health parity requirements.
6k. Notwithstanding any provision to the contrary, for the
7fiscal year beginning July 1, 2021, the reimbursement rate for
8anesthesiologists shall remain at the rates in effect on June
930, 2021, and updated on January 1, 2022, to align with the
10most current Iowa Medicare anesthesia rate.
11l. Notwithstanding section 249A.20, for the fiscal year
12beginning July 1, 2021, the average reimbursement rate for
13health care providers eligible for use of the federal Medicare
14resource-based relative value scale reimbursement methodology
15under section 249A.20 shall remain at the rate in effect on
16June 30, 2021; however, this rate shall not exceed the maximum
17level authorized by the federal government.
18m. For the fiscal year beginning July 1, 2021, the
19reimbursement rate for residential care facilities shall not
20be less than the minimum payment level as established by the
21federal government to meet the federally mandated maintenance
22of effort requirement. The flat reimbursement rate for
23facilities electing not to file annual cost reports shall not
24be less than the minimum payment level as established by the
25federal government to meet the federally mandated maintenance
26of effort requirement.
27n. For the fiscal year beginning July 1, 2021, the
28reimbursement rates for inpatient mental health services
29provided at hospitals shall be rebased effective October 1,
302021, subject to Medicaid program upper payment limit rules
31and adjusted as necessary to maintain expenditures within the
32amount appropriated to the department for this purpose for
33the fiscal year; and psychiatrists shall be reimbursed at the
34medical assistance program fee-for-service rate in effect on
35June 30, 2021.
-58- 1o. For the fiscal year beginning July 1, 2021, community
2mental health centers may choose to be reimbursed for the
3services provided to recipients of medical assistance through
4either of the following options:
5(1) For 100 percent of the reasonable costs of the services.
6(2) In accordance with the alternative reimbursement rate
7methodology approved by the department of human services in
8effect on June 30, 2021.
9p. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers of family planning services
11that are eligible to receive a 90 percent federal match shall
12remain at the rates in effect on June 30, 2021.
13q. (1) For the fiscal year beginning July 1, 2021,
14reimbursement rates for providers of home and community-based
15services waiver and habilitation services shall be increased
16to the extent possible within the $11,002,240 appropriated for
17this purpose.
18(2) For the fiscal year beginning July 1, 2021,
19reimbursement rates for providers of state plan home and
20community-based services home-based habilitation services
21shall be increased with the $7,134,214 appropriated for this
22purpose. The reimbursement rates for home-based habilitation
23services shall be based on a fee schedule that incorporates the
24acuity-based tiers.
25r. For the fiscal year beginning July 1, 2021, the
26reimbursement rates for emergency medical service providers
27shall remain at the rates in effect on June 30, 2021, or as
28approved by the centers for Medicare and Medicaid services of
29the United States department of health and human services.
30s. For the fiscal year beginning July 1, 2021, reimbursement
31rates for substance-related disorder treatment programs
32licensed under section 125.13 shall remain at the rates in
33effect on June 30, 2021.
34t. For the fiscal year beginning July 1, 2021, assertive
35community treatment per diem rates shall remain at the rates in
-59-1effect on June 30, 2021.
2u. For the fiscal year beginning July 1, 2021, the
3reimbursement rate for family-centered services providers shall
4be established by contract.
5v. For the fiscal year beginning July 1, 2021, the
6reimbursement rate for air ambulance services shall be
7increased to the extent possible within the additional $100,000
8appropriated for this purpose.
92. For the fiscal year beginning July 1, 2021, the
10reimbursement rate for providers reimbursed under the
11in-home-related care program shall not be less than the minimum
12payment level as established by the federal government to meet
13the federally mandated maintenance of effort requirement.
143. Unless otherwise directed in this section, when the
15department’s reimbursement methodology for any provider
16reimbursed in accordance with this section includes an
17inflation factor, this factor shall not exceed the amount
18by which the consumer price index for all urban consumers
19increased during the calendar year ending December 31, 2002.
204. Notwithstanding section 234.38, for the fiscal
21year beginning July 1, 2021, the foster family basic daily
22maintenance rate and the maximum adoption subsidy rate for
23children ages 0 through 5 years shall be $16.78, the rate for
24children ages 6 through 11 years shall be $17.45, the rate for
25children ages 12 through 15 years shall be $19.10, and the
26rate for children and young adults ages 16 and older shall
27be $19.35. For youth ages 18 to 23 who have exited foster
28care, the preparation for adult living program maintenance
29rate shall be up to $602.70 per month as calculated based on
30the age of the participant. The maximum payment for adoption
31subsidy nonrecurring expenses shall be limited to $500 and the
32disallowance of additional amounts for court costs and other
33related legal expenses implemented pursuant to 2010 Iowa Acts,
34chapter 1031, section 408, shall be continued.
355. For the fiscal year beginning July 1, 2021, the maximum
-60-1reimbursement rates for social services providers under
2contract shall remain at the rates in effect on June 30, 2021,
3or the provider’s actual and allowable cost plus inflation for
4each service, whichever is less. However, if a new service
5or service provider is added after June 30, 2021, the initial
6reimbursement rate for the service or provider shall be based
7upon a weighted average of provider rates for similar services.
86. a. For the fiscal year beginning July 1, 2021, the
9reimbursement rates for resource family recruitment and
10retention contractors shall be established by contract.
11b. For the fiscal year beginning July 1, 2021, the
12reimbursement rates for supervised apartment living foster care
13providers shall be established by contract.
147. For the fiscal year beginning July 1, 2021, the
15reimbursement rate for group foster care providers shall be the
16combined service and maintenance reimbursement rate established
17by contract.
188. The group foster care reimbursement rates paid for
19placement of children out of state shall be calculated
20according to the same rate-setting principles as those used for
21in-state providers, unless the director of human services or
22the director’s designee determines that appropriate care cannot
23be provided within the state. The payment of the daily rate
24shall be based on the number of days in the calendar month in
25which service is provided.
269. a. For the fiscal year beginning July 1, 2021, the
27reimbursement rate paid for shelter care and the child welfare
28emergency services implemented to provide or prevent the need
29for shelter care shall be established by contract.
30b. For the fiscal year beginning July 1, 2021, the combined
31service and maintenance components of the reimbursement rate
32paid for shelter care services shall be based on the financial
33and statistical report submitted to the department. The
34maximum reimbursement rate shall be $101.83 per day. The
35department shall reimburse a shelter care provider at the
-61-1provider’s actual and allowable unit cost, plus inflation, not
2to exceed the maximum reimbursement rate.
3c. Notwithstanding section 232.141, subsection 8, for the
4fiscal year beginning July 1, 2021, the amount of the statewide
5average of the actual and allowable rates for reimbursement of
6juvenile shelter care homes that is utilized for the limitation
7on recovery of unpaid costs shall remain at the amount in
8effect for this purpose in the fiscal year beginning July 1,
92020.
1010. For the fiscal year beginning July 1, 2021, the
11department shall calculate reimbursement rates for intermediate
12care facilities for persons with an intellectual disability
13at the 80th percentile. Beginning July 1, 2021, the rate
14calculation methodology shall utilize the consumer price index
15inflation factor applicable to the fiscal year beginning July
161, 2021.
1711. Effective July 1, 2021, the department of human services
18shall set the reimbursement rate of child care providers whose
19reimbursement rates are below the fiftieth percentile of the
20most recent market rate survey at the fiftieth percentile of
21the most recent market rate survey. Reimbursement rates of
22child care providers whose reimbursement rates are at or above
23the fiftieth percentile of the most recent market rate survey
24shall remain at the rates in effect on June 30, 2021. The
25department shall also adjust quality rating system bonuses to
26reflect increased child care provider reimbursement rates as
27appropriate. The department shall set rates in a manner so as
28to provide incentives for a nonregistered provider to become
29registered by applying any increase only to registered and
30licensed providers.
3112. The department may adopt emergency rules to implement
32this section.
33 Sec. 32. EMERGENCY RULES.
341. If necessary to comply with federal requirements
35including time frames, or if specifically authorized by a
-62-1provision of this division of this Act, the department of
2human services or the mental health and disability services
3commission may adopt administrative rules under section 17A.4,
4subsection 3, and section 17A.5, subsection 2, paragraph “b”,
5to implement the provisions of this division of this Act and
6the rules shall become effective immediately upon filing or
7on a later effective date specified in the rules, unless the
8effective date of the rules is delayed or the applicability
9of the rules is suspended by the administrative rules review
10committee. Any rules adopted in accordance with this section
11shall not take effect before the rules are reviewed by the
12administrative rules review committee. The delay authority
13provided to the administrative rules review committee under
14section 17A.4, subsection 7, and section 17A.8, subsections
159 and 10, shall be applicable to a delay imposed under this
16section, notwithstanding a provision in those subsections
17making them inapplicable to section 17A.5, subsection 2,
18paragraph “b”. Any rules adopted in accordance with the
19provisions of this section shall also be published as a notice
20of intended action as provided in section 17A.4.
212. If during a fiscal year, the department of human
22services is adopting rules in accordance with this section
23or as otherwise directed or authorized by state law, and
24the rules will result in an expenditure increase beyond the
25amount anticipated in the budget process or if the expenditure
26was not addressed in the budget process for the fiscal
27year, the department shall notify the general assembly and
28the department of management concerning the rules and the
29expenditure increase. The notification shall be provided at
30least 30 calendar days prior to the date notice of the rules
31is submitted to the administrative rules coordinator and the
32administrative code editor.
33 Sec. 33. REPORTS. Unless otherwise provided, any reports or
34other information required to be compiled and submitted under
35this Act during the fiscal year beginning July 1, 2021, shall
-63-1be submitted on or before the dates specified for submission
2of the reports or information.
3 Sec. 34. EFFECTIVE UPON ENACTMENT. The following provision
4of this division of this Act, being deemed of immediate
5importance, takes effect upon enactment:
61. The provision relating to section 232.141 and directing
7the state court administrator and the division administrator of
8the department of human services division of child and family
9services to make the determination, by June 15, 2021, of the
10distribution of funds allocated for the payment of the expenses
11of court-ordered services provided to juveniles which are a
12charge upon the state.
13DIVISION VI
14HEALTH CARE ACCOUNTS AND FUNDS — FY 2021-2022
15 Sec. 35. PHARMACEUTICAL SETTLEMENT ACCOUNT. There is
16appropriated from the pharmaceutical settlement account created
17in section 249A.33 to the department of human services for the
18fiscal year beginning July 1, 2021, and ending June 30, 2022,
19the following amount, or so much thereof as is necessary, to be
20used for the purpose designated:
21Notwithstanding any provision of law to the contrary, to
22supplement the appropriations made in this Act for health
23program operations under the medical assistance program for the
24fiscal year beginning July 1, 2021, and ending June 30, 2022:
.................................................. $25234,193
26 Sec. 36. QUALITY ASSURANCE TRUST FUND — DEPARTMENT OF HUMAN
27SERVICES. Notwithstanding any provision to the contrary and
28subject to the availability of funds, there is appropriated
29from the quality assurance trust fund created in section
30249L.4 to the department of human services for the fiscal year
31beginning July 1, 2021, and ending June 30, 2022, the following
32amounts, or so much thereof as is necessary, for the purposes
33designated:
34To supplement the appropriation made in this Act from the
35general fund of the state to the department of human services
-64-1for medical assistance for the same fiscal year:
.................................................. $256,305,139
3 Sec. 37. HOSPITAL HEALTH CARE ACCESS TRUST FUND —
4DEPARTMENT OF HUMAN SERVICES. Notwithstanding any provision to
5the contrary and subject to the availability of funds, there is
6appropriated from the hospital health care access trust fund
7created in section 249M.4 to the department of human services
8for the fiscal year beginning July 1, 2021, and ending June
930, 2022, the following amounts, or so much thereof as is
10necessary, for the purposes designated:
11To supplement the appropriation made in this Act from the
12general fund of the state to the department of human services
13for medical assistance for the same fiscal year:
.................................................. $1433,920,554
15 Sec. 38. MEDICAL ASSISTANCE PROGRAM — NONREVERSION
16FOR FY 2021-2022. Notwithstanding section 8.33, if moneys
17appropriated for purposes of the medical assistance program for
18the fiscal year beginning July 1, 2021, and ending June 30,
192022, from the general fund of the state, the quality assurance
20trust fund, and the hospital health care access trust fund, are
21in excess of actual expenditures for the medical assistance
22program and remain unencumbered or unobligated at the close
23of the fiscal year, the excess moneys shall not revert but
24shall remain available for expenditure for the purposes of the
25medical assistance program until the close of the succeeding
26fiscal year.
27DIVISION VII
28NURSING FACILITY REIMBURSEMENT METHODOLOGY — FISCAL PERIOD
29JULY 1, 2023, THROUGH JUNE 30, 2025
30 Sec. 39. NURSING FACILITY REIMBURSEMENT METHODOLOGY —
31FISCAL PERIOD JULY 1, 2023, THROUGH JUNE 30, 2025.
32Notwithstanding any provision of law to the contrary, for the
33fiscal period beginning July 1, 2023, and ending June 30, 2025,
34the department of human services shall rebase case-mix nursing
35facility rates beginning July 1, 2023, using the Medicaid cost
-65-1reports on file for the period ending December 31, 2022, and
2applying a minimum occupancy factor of 70 percent.
3DIVISION VIII
4NURSING FACILITY REIMBURSEMENT STUDY
5 Sec. 40. NURSING FACILITY CASE-MIX REIMBURSEMENT — STUDY
6AND RECOMMENDATIONS. The department of human services shall
7convene a workgroup including representatives of nursing
8facilities, managed care organizations, and other appropriate
9stakeholders to review the case-mix reimbursement methodology
10and process for nursing facilities, including but not limited
11to rebasing, the use of cost reports, and the application
12of quarterly case-mix index adjustments, and shall submit
13recommendations to the governor and the general assembly by
14December 1, 2021, for improvements including those related to
15the methodology, the process, the use of prospective payments,
16and the applicable time frames to increase efficiencies
17and accuracy in the determination of reimbursements, reduce
18duplication of effort, more adequately reflect the actual costs
19of care, address changes in patient acuity levels without
20reliance on retroactive rate adjustments, and incentivize
21quality outcomes.
22DIVISION IX
23MEDICAID-ELIGIBLE CHILDREN — PEDIATRIC HEALTH CARE SERVICES
24 Sec. 41. MEDICAID-ELIGIBLE CHILDREN — PROVISION OF
25PEDIATRIC HEALTH CARE SERVICES — REVIEW AND REPORT. The
26department of human services shall review federal Medicare
27and state law and administrative rule restrictions related
28to the provision of physical therapy, occupational therapy,
29speech-language pathology, applied behavior analysis, and other
30pediatric health care services to Medicaid-eligible children
31to determine necessary changes in law and policy to ensure
32that these services are provided consistent with the early and
33periodic screening, diagnostic, and treatment program. The
34department shall submit a report including the findings of the
35review and recommendations to the governor and the general
-66-1assembly by October 1, 2021.
2DIVISION X
3DECATEGORIZATION CARRYOVER FUNDING
4 Sec. 42. DECATEGORIZATION CARRYOVER FUNDING FY 2019 —
5TRANSFER TO MEDICAID PROGRAM. Notwithstanding section 232.188,
6subsection 5, paragraph “b”, any state-appropriated moneys in
7the funding pool that remained unencumbered or unobligated
8at the close of the fiscal year beginning July 1, 2018, and
9were deemed carryover funding to remain available for the two
10succeeding fiscal years that still remain unencumbered or
11unobligated at the close of the fiscal year beginning July 1,
122020, shall not revert but shall be transferred to the medical
13assistance program for the fiscal year beginning July 1, 2021.
14 Sec. 43. EFFECTIVE DATE. This division of this Act, being
15deemed of immediate importance, takes effect upon enactment.
16 Sec. 44. RETROACTIVE APPLICABILITY. This division of this
17Act applies retroactively to July 1, 2020.
18DIVISION XI
19PRIOR APPROPRIATIONS AND OTHER PROVISIONS
20COURT-ORDERED SERVICES REIMBURSEMENT BY MANAGED CARE
21ORGANIZATIONS
22 Sec. 45. 2018 Iowa Acts, chapter 1165, section 128,
23subsection 2, paragraph a, is amended to read as follows:
24a. If a Medicaid member is receiving court-ordered services
25or treatment for a substance-related disorder pursuant to
26chapter 125 or for a mental illness pursuant to chapter 229,
27such services or treatment shall be provided and reimbursed
28for an initial period of three days before a managed care
29organization may apply medical necessity criteria to determine
30the most appropriate services, treatment, or placement for the
31Medicaid member.
32FAMILY INVESTMENT PROGRAM ACCOUNT
33 Sec. 46. 2019 Iowa Acts, chapter 85, section 9, as amended
34by 2020 Iowa Acts, chapter 1121, section 20, is amended by
35adding the following new subsection:
-67-1 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
2appropriated in this section that remain unencumbered or
3unobligated at the close of the fiscal year shall not revert
4but shall remain available for expenditure for the purposes
5designated, and may be transferred to other appropriations made
6in this division of this Act as necessary to carry out the
7initiatives included in the report submitted on nonreversion
8of funds required pursuant to 2020 Iowa Acts, chapter 1121,
9section 43, until the close of the succeeding fiscal year.
10Child and family services
11 Sec. 47. 2019 Iowa Acts, chapter 85, section 19, as amended
12by 2020 Iowa Acts, chapter 1121, section 23, is amended by
13adding the following new subsection:
14 NEW SUBSECTION. 25. Notwithstanding section 8.33, moneys
15appropriated in this section that remain unencumbered or
16unobligated at the close of the fiscal year shall not revert
17but shall remain available for expenditure for the purpose of
18the redesign of the child welfare system, until the close of
19the succeeding fiscal year.
20FIELD OPERATIONS
21 Sec. 48. 2019 Iowa Acts, chapter 85, section 27, as amended
22by 2020 Iowa Acts, chapter 1121, section 25, is amended by
23adding the following new subsection:
24 NEW SUBSECTION. 5. Notwithstanding section 8.33, moneys
25appropriated in this section that remain unencumbered or
26unobligated at the close of the fiscal year shall not revert
27but shall remain available for expenditure for the purposes
28designated until the close of the succeeding fiscal year.
29GENERAL ADMINISTRATION
30 Sec. 49. 2019 Iowa Acts, chapter 85, section 28, as amended
31by 2020 Iowa Acts, chapter 1121, section 26, is amended by
32adding the following new subsection:
33 NEW SUBSECTION. 8. Notwithstanding section 8.33, moneys
34appropriated in this section that remain unencumbered or
35unobligated at the close of the fiscal year shall not revert
-68-1but shall remain available for expenditure for the purposes
2designated until the close of the succeeding fiscal year.
3 Sec. 50. EFFECTIVE DATE. This division of this Act, being
4deemed of immediate importance, takes effect upon enactment.
5DIVISION XII
6EXTENSION OF FUTURE REPEAL — HOSPITAL HEALTH CARE ACCESS
7ASSESSMENT PROGRAM
8 Sec. 51. Section 249M.5, Code 2021, is amended to read as
9follows:
10249M.5 Future repeal.
11This chapter is repealed July 1, 2021 2023.
12 Sec. 52. EFFECTIVE DATE. This division of this Act, being
13deemed of immediate importance, takes effect upon enactment.
14DIVISION XIII
15PUBLIC HEALTH EMERGENCY PROVISIONS COVID-19 REGULATIONS
16 Sec. 53. COVID-19 FEDERAL REGULATIONS. For the time
17period beginning on the effective date of this division of
18this Act, and ending June 30, 2022, notwithstanding state
19administrative rules to the contrary, to the extent federal
20regulations relating to the COVID-19 pandemic differ from state
21administrative rules, including applicable federal waivers,
22the federal regulations are controlling during the pendency of
23the federally declared state of emergency and for such period
24of time following the end of the federally declared state of
25emergency applicable to the respective federal regulations.
26DIVISION XIV
27FOSTER HOME INSURANCE FUND
28 Sec. 54. Section 237.13, subsection 2, Code 2021, is amended
29to read as follows:
302. The foster home insurance fund shall be administered by
31the department of human services. The fund shall consist of
32all moneys appropriated by the general assembly for deposit
33in the fund. The department shall use moneys in the fund to
34provide home and property coverage for foster parents to cover
35damages to property resulting from the actions of a foster
-69-1child residing in a foster home or to reimburse foster parents
2for the cost of purchasing foster care liability insurance and
3to perform the administrative functions necessary to carry out
4this section. The department may establish limitations of
5liability for individual claims as deemed reasonable by the
6department.
7DIVISION XV
8MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER OF FUNDS
9 Sec. 55. MENTAL HEALTH AND DISABILITY SERVICES — TRANSFER
10OF FUNDS. Notwithstanding section 331.432, a county with a
11population of over 300,000 based on the 2010 federal decennial
12census may transfer funds from any other fund of the county to
13the mental health and disability regional services fund for the
14purposes of providing mental health and disability services for
15the fiscal year beginning July 1, 2021, and ending June 30,
162022. The county shall submit a report to the governor and the
17general assembly by September 1, 2022, including the source of
18any funds transferred, the amount of the funds transferred, and
19the mental health and disability services provided with the
20transferred funds. The county shall work with the department
21to maximize the use of the medical assistance program and other
22third-party payment sources, including but not limited to
23identifying individuals enrolled with or eligible for Medicaid
24whose Medicaid-covered services are being paid by the county or
25could be converted to Medicaid-covered services.
26DIVISION XVI
27IN-PERSON SUPERVISION REQUIREMENTS FOR LICENSURE — CERTAIN
28PROFESSIONALS
29 Sec. 56. Section 154C.3, subsection 1, paragraph c,
30subparagraph (5), subparagraph division (a), Code 2021, is
31amended by adding the following new subparagraph subdivision:
32 NEW SUBPARAGRAPH SUBDIVISION. (0ii) By a person licensed
33under section 154D.2 to practice marital and family therapy
34without supervision or mental health counseling without
35supervision.
-70-1 Sec. 57. Section 154C.3, Code 2021, is amended by adding the
2following new subsection:
3 NEW SUBSECTION. 4. Supervision. The board shall not, by
4rule or other means, require that supervision be completed in
5person as a condition for an applicant to receive a license, a
6reciprocal license, or a renewed license under this chapter.
7 Sec. 58. Section 154D.2, Code 2021, is amended to read as
8follows:
9154D.2 Licensure — marital and family therapy — mental
10health counseling.
111. An applicant for a license to practice marital and family
12therapy or mental health counseling shall be granted a license
13by the board when the applicant satisfies all of the following
14requirements:
151. a. Possesses a master’s degree in marital and family
16therapy or mental health counseling, as applicable, consisting
17of at least sixty semester hours, or its equivalent, from a
18nationally accredited institution or from a program approved
19by the board.
202. b. Has at least two years of supervised clinical
21experience or its equivalent as approved by the board.
22Standards for supervision, including the required
23qualifications for supervisors, shall be determined in
24accordance with subsection 2 and by the board by rule, provided
25that a supervisor may be a person licensed under this section
26to practice marital and family therapy or mental health
27counseling without supervision or a licensed independent social
28worker licensed under chapter 154C.
293. c. Passes an examination approved by the board.
302. The board shall not, by rule or other means, require any
31in-person supervised clinical experience.
32 Sec. 59. Section 154D.4, subsection 2, paragraph b, Code
332021, is amended to read as follows:
34b. A person who practices marital and family therapy or
35mental health counseling under the supervision of a person
-71-1licensed under this chapter as part of a clinical experience as
2described in section 154D.2, subsection 2 1, paragraph “b”.
3 Sec. 60. BOARD OF SOCIAL WORK AND BOARD OF BEHAVIORAL
4SCIENCE — RULES. The board of social work and the board
5of behavioral science shall amend their administrative
6rules pursuant to chapter 17A to remove any requirement for
7supervised clinical experience and supervised professional
8practice to be completed in person as a condition for the
9licensure of marital and family therapists, mental health
10counselors, and social workers pursuant to chapters 154C and
11154D. The board of social work and the board of behavioral
12science shall replace all licensing requirements for in-person
13supervision with the ability to have supervision requirements
14completed electronically.
15 Sec. 61. EMERGENCY RULES.
161. The board of social work and the board of behavioral
17science shall adopt emergency rules under section 17A.4,
18subsection 3, and section 17A.5, subsection 2, to implement
19the sections of this division of this Act amending section
20154C.3 and section 154D.2, and the rules shall be effective
21immediately upon filing unless a later date is specified in the
22rules. Any emergency rules adopted in accordance with this
23section shall also be published as a notice of intended action
24as provided in section 17A.4, subsection 1.
252. The board of social work and the board of behavioral
26science shall jointly develop rules adopted pursuant to this
27subsection through a collaborative process. The respective
28boards may establish subcommittees or designate other personnel
29to facilitate such a process. Such rules shall consist of
30substantively identical standards applicable to the professions
31regulated by the respective boards and shall, to the greatest
32extent possible, consist of substantially similar language
33in a substantially similar format. Prior to a vote to adopt
34such rules by either board, each board shall, by a separate
35vote, approve the language to be adopted by the other board.
-72-1Neither board shall vote to adopt such rules until the rules
2to be adopted by both boards have been so approved. Such rules
3shall have the same effective date and shall be submitted to
4the administrative rules coordinator and the administrative
5code editor for publication in the same issue of the Iowa
6administrative bulletin pursuant to sections 17A.4 and 17A.5.
7 Sec. 62. EFFECTIVE DATE. This division of this Act, being
8deemed of immediate importance, takes effect upon enactment.
9DIVISION XVII
10MEDICAL RESIDENCY LIABILITY COSTS
11 Sec. 63. Section 135.176, subsection 1, Code 2021, is
12amended by adding the following new paragraph:
13 NEW PARAGRAPH. d. For the period beginning July 1, 2021,
14and ending June 30, 2026, the payment by the sponsor of medical
15residency program liability costs subject to provision by the
16sponsor of dollar-for-dollar matching funds used for payment
17of such costs. This paragraph shall not apply to medical
18residency programs to which chapter 669 applies.
19 Sec. 64. Section 135.176, subsection 2, paragraphs e and f,
20Code 2021, are amended to read as follows:
21e. The maximum award of grant funds to a particular
22individual sponsor per year. An individual sponsor that
23establishes a new or alternative campus accredited medical
24residency training program as defined in subsection 1,
25paragraph “a”, shall not receive more than fifty percent
26of the state matching funds available each year to support
27the program. An individual sponsor proposing the provision
28of a new residency position within an existing accredited
29medical residency or fellowship training program as specified
30in subsection 1, paragraph “b”, or the funding of residency
31positions which are in excess of the federal residency cap as
32defined in subsection 1, paragraph “c”, or the funding of the
33payment by the sponsor of medical residency program liability
34costs subject to provision by the sponsor of dollar-for-dollar
35matching funds used for payment of such costs as specified
-73-1in subsection 1, paragraph “d”, shall not receive more than
2twenty-five percent of the state matching funds available each
3year to support the program.
4f. Use of the funds awarded. Funds may be used to pay the
5costs of establishing, expanding, or supporting an accredited
6graduate medical education program as specified in this
7section, including but not limited to the costs associated
8with residency stipends and physician faculty stipends. For
9the period beginning July 1, 2021, and ending June 30, 2026,
10use of the funds awarded may include payment by the sponsor of
11medical residency program liability costs in accordance with
12subsection 1, paragraph “d”, and subject to provision by the
13sponsor of dollar-for-dollar matching funds used for payment
14of such costs.
15DIVISION XVIII
16REPORT ON NONREVERSION OF FUNDS
17 Sec. 65. REPORT ON NONREVERSION OF FUNDS. The department
18of human services shall report the expenditure of any moneys
19for which nonreversion authorization was provided for the
20fiscal year beginning July 1, 2020, and ending June 30, 2021,
21for field operations or general administration to the general
22assembly on a quarterly basis beginning October 1, 2021.
23DIVISION XIX
24PHYSICIAN ORDERS FOR SCOPE OF TREATMENT
25 Sec. 66. Section 144D.2, subsection 1, paragraph e,
26subparagraph (4), Code 2021, is amended by striking the
27subparagraph.
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